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  • 1
    Electronic Resource
    Electronic Resource
    New radiolucent head fixation made of engineering plastics for intraoperative CT scanning (1994)
    Springer
    Acta neurochirurgica 127 (1994), S. 121-123 
    Details
    ISSN: 0942-0940
    Keywords: Instrumentation ; head fixation ; intraoperative CT ; open neurosurgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A newly developed head fixation for intraoperative computerized tomographic (IOCT) scanning is presented. The system is developed based on the head holder of multipurpose head frame and is made of two kinds of advanced engineering material; carbon fiber reinforced plastic for head holder and frames, polyamide-imide polymer for joints, screws, and head pin. Clinical tests including autoclaving and sterilization were performed and revealed all materials had sufficient strength for clinical use. This fixation system enables us to increase the efficacy of IOCT scanning during open-field neurosurgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01808559
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Indications and limitations for CT-guided stereotaxic surgery of hypertensive intracerebral haemorrhage, based on the analysis of postoperative complications and poor ability of daily living in 158 cases (1993)
    Springer
    Acta neurochirurgica 125 (1993), S. 27-33 
    Details
    ISSN: 0942-0940
    Keywords: CT-guided stereotaxic surgery ; postoperative complications ; indications ; limitations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors have studied the indications and limitations for computerized tomography (CT) -guided stereotaxic surgery (CTGS Surgery) of hypertensive intracerebral haematomas (ICH), based on the analysis of 158 patients in our institutions. Of 158 patients, 120 had putaminal haemorrhage, 21 thalamic, 14 subcortical and 3 in other locations. The patients ranged in age from 37 to 82 years (average 60). Haematoma volume ranged from 8 to 140 ml (average 43). Eleven patients in the series worsened postoperatively because of rebleeding in 6 cases, cerebral infarction in 2, and unknown causes in the remaining 3 cases. Seven of the 11 patients pre-operatively had untreated hypertension and 3 had mild liver dysfunction without major haemorrhagic tendency. Most postoperative complications were seen in older patients and in those with severe neurological deficit or chronic disease. All these cases ended in poor outcome. From our study, we propose three indications for CTGS Surgery: absolute, aggressive and passive indications. The absolute indication is applied to those who would have been operated on by conventional open surgery. The aggressive indication is for those with mild neurological deficit so that early rehabilitation can be started to regain higher cerebral function. The passive indication is for elderly patients and those with severe neurological deficit or chronic disease. This indication must be decided carefully because poor outcome is likely.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01401824
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Cranioplasty with a frozen and autoclaved bone flap (1990)
    Springer
    Acta neurochirurgica 102 (1990), S. 38-41 
    Details
    ISSN: 0942-0940
    Keywords: Autoclaving ; autogenous bone graft ; cranioplasty ; freezing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 27 cases of cranioplasty with autogenous bone grafts stored in a deep-freezer and autoclaved before use are reported. The results of follow-up for an average period of one year were satisfactory from the standpoint of brain protection and cosmetic reconstruction. A small area of absorption of grafted bone was observed in two cases on the follow-up skull roentgenograms. No serious complications were seen except in one case, whose bone flap had to be removed due to an epidural abscess. Experiments revealed that deep-freezing and autoclaving had only minimal effects on bone structure, although osteocytes degenerated. Autogenous bone flap after deep-freezing is a useful material for cranioplasty but sterilization before use is indispensable. Autoclaving is a simple method for sterilization of the flap, available in any operating theatre. It does not increase the risk of postoperative complications such as infection or absorption.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01402184
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Normovolaemic induced hypertension therapy for cerebral vasospasm after subarachnoid haemorrhage (1990)
    Springer
    Acta neurochirurgica 103 (1990), S. 18-26 
    Details
    ISSN: 0942-0940
    Keywords: Cerebral vasospasm ; haemorrhagic infarction ; intracranial aneurysm ; normovolaemic induced hypertension therapy ; subarachnoid haemorrhage ; Swan-Ganz catheter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We showed that normovolaemic induced hypertension therapy was effective in reducing ischaemic symptoms attributed to cerebral vasospasm in 41 patients after subarachnoid haemorrhage. By inducing hypertension to 25% to 50% above normal systolic arterial blood pressure, we observed that in 17 of 24 cases (71%) neurological deficits improved. In four cases of haemorrhagic infarction, the blood pressure rose to over 50% of systolic arterial pressure, and a low density area was confirmed on computerized tomography (CT) scan prior to vasospasm. Induced hypertension was therefore not considered when a low density area was revealed on CT scan. Restriction of fluid input is usually a factor in producing hypovolaemia after a neurosurgical operation. Intravascular volume expansion has been reported effective in reversing ischaemic deficits. However, according to Poiseuille's equation, increasing blood volume to a state of hypervolaemia can not enhance flow. The cerebral blood flow (CBF) was raised by increasing perfusion pressure, reducing viscosity, or increasing blood vessel diameter. Intravascular volume expansion elevates not only systemic arterial pressure, but also pulmonary artery wedge pressure over 18 mmHg and cardiac index over 2.2. Since pulmonary oedema and congestive heart failure may develop, one should monitor haemodynamic parameters with the Swan-Ganz catheter as a preventive measure. We emphasize that normovolaemic induced hypertension, maintaining haemodynamics subset 1 of the comparable haemodynamic subsets, is effective in raising perfusion pressure of CBF.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01420187
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    Paper (German National Licenses)
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