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  • 1
    Digitale Medien
    Digitale Medien
    Springer
    Acta neurochirurgica 106 (1990), S. 127-131 
    ISSN: 0942-0940
    Schlagwort(e): Aneurysm ; grade 5 ; outcome ; subarachnoid haemorrhage
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary The purpose of the present study was to describe the clinical course of patients with Grade-5 ruptured aneurysms (WFNS grading). Among 250 consecutive cases of ruptured aneurysms, 60 Grade-5 patients were reviewed retrospectively, consisting of 24 males and 36 females with an average age of 58 years. Thirty-two patients were directly transferred to our clinic, while the remaining 28 were referred from other clinics. Duration from rupture to arrival at our clinic was within 1 hour in 25 cases and within 2 hours in 43 cases. Systolic blood pressure on admission was 186 mmHg on average. Obvious misdiagnoses by primary physicians were made in 7 cases. Ventricular drainage and clipping/trapping of the aneurysms were performed in 7 and 25 cases, respectively. Forty-nine patients died and the remaining 11 survived. One made a good recovery, 1 was moderately disabled, 8 severely disabled, and 1 in a vegetative state. The prognosis for Grade-5 patients is well known as being extremely poor, which also was the case in our series. Early referral and early surgical intervention have not changed this poor prognosis. Possible improvement of the outcome of this group might be expected by 1) public health and primary physician education on aneurysmal subarachnoid haemorrhage, and 2) control of blood pressure during referral.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    ISSN: 1432-1920
    Schlagwort(e): Magnetic resonance imaging ; Intraspinal tumor ; Meningioma ; Schwannoma
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Summary Magnetic resonance (MR) images of 29 consecutive patients with intraspinal neoplasms (9 intramedullary tumors, 20 extramedullary tumors) were reviewed to evaluated the utility of MR imaging in distinguishing the intraspinal compartmental localisation and signal characteristics of each lesion. Compartment and histology of all neoplasms were surgically proven. MR correctly assigned one of three compartments to all lesions, 9 intramedullary, 14 intradural extramedullary (6 schwannomas, 3 neurofibromas, 5 meningiomas), and 6 extradural (3 schwannomas, 1 meningioma, 1 cavernous hemangioma, 1 metastatic renal cell carcinoma). All intramedullary tumors showed swelling of the spinal cord itself. In all five extradural tumors a low intensity band was visualized between the spinal cord and tumor. On the other hand, a low intensity band was demonstrated in no cases with intradural tumors. Visualization of this low intensity band is important in differentiating extradural from intradural-extramedullary lesions. We call this low intensity band, “the extradural sign”. Signal intensity of intradural tumors varied with histology. In extramedullary tumors, signal intensity of schwannomas was similar to that of the cerebrospinal fluid (CSF) both on T1 weighted (inversion recovery) and T2 weighted spin echo (SE) images. On the other hand, meningiomas tended to be isointense to the spinal cord on both T1 and T2 weighted SE images. We found relatively reliable signal characteristics to discriminate meningioma from schwannoma.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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