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  • 1
    Electronic Resource
    Electronic Resource
    Analysis of the angiographic findings in cases of childhood moyamoya disease (1988)
    Springer
    Neuroradiology 30 (1988), S. 111-119 
    Details
    ISSN: 1432-1920
    Keywords: Childhood moyamoya disease ; Cerebral angiography ; Stenosis ; Collateral pathways ; Aneurysm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cerebral angiograms of 34 patients with childhood moyamoya disease have been analysed, this analysis having revealed the following findings. The blood flow to abnormal net-like vessels (ANV) in the base of the brain is mainly supplied from the internal carotid artery (ICA) in the early stage of this disease. In a later stage, however, the blood supply is mainly from the posterior cerebral artery (PCA). Though, no remarkable change was found in the volumes of ANV from the early to later stages of the disease, the leptomeningeal collaterals, the most prominent anastomoses in moyamoya disease, had a tendency to decrease during the later stage with the development of PCA stenosis. Eighteen occlusive PCA lesions were found in the proximal portion of the PCA in eight cases (44%), and in the distal in nine cases (50%). The incidence of aneurysm (1.5%) and intracranial bleeding was low as compared to cases of adult moyamoya disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00395611
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  • 2
    Electronic Resource
    Electronic Resource
    Childhood moyamoya disease before and after encephalo-duro-arterio-synangiosis: an angiographic study (1992)
    Springer
    Neuroradiology 34 (1992), S. 318-322 
    Details
    ISSN: 1432-1920
    Keywords: Childhood moyamoya disease ; Encephalo-duro-arterio-synangiosis ; Cerebral angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Encephalo-duro-arterio-synangiosis (EDAS) is a new surgical operation for childhood moyamoya disease, and its effects have been studied by comparing pre-and postoperative angiograms in 27 patients. The development of collaterals from the external carotid arterial system into the territory of the middle cerebral artery was excellent in 16 of 54 cerebral hemispheres after EDAS, good in 25, and poor in 13. The development of collaterals after EDAS increased as the stenotic process in the internal carotid artery on preoperative angiograms increased except in the most advanced cases, where it seemed to decrease in comparison with the group with middle grade stenosis. After EDAS, not only the superficial temporal artery, but also the adjacent middle meningeal artery participated in forming collateral pathways. Furthermore, decrease of abnormal net-like vessels was observed when there was good to excellent development of collateral vessels. Stenotic lesions in the internal carotid and posterior cerebral arteries were often seen to progress, indicative of the rapidly progressive nature of childhood moyamoya disease. These results appear to suggest that EDAS should be performed as early as possible in childhood moyamoya disease before the occurrence of an irreversible ischaemic state and/or permanent neurological defects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00588191
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Moyamoya disease: diagnostic accuracy of MRI (1995)
    Springer
    Neuroradiology 37 (1995), S. 356-361 
    Details
    ISSN: 1432-1920
    Keywords: Moyamoya disease ; Magnetic resonance imaging ; Cerebral angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our purpose was to evaluate the diagnostic accuracy of MRI in moyamoya disease. We studied 30 patients with this disease, comparing MRI and angiographic findings. The diagnostic value of MRI was evaluated for occlusive lesions, collateral vessels, and parenchymal lesions. In all patients bilateral occlusion or stenosis of the supraclinoid internal carotid artery and proximal anterior and middle cerebral arteries was clearly shown by MRI, and staging of the extent of occlusion agreed with angiographic staging in 44 (73%) of 60 arteries. MRI, particularly coronal images, clearly showed basal cerebral moyamoya vessels in 54 hemispheres, and 45 of a total of 71 large leptomeningeal and transdural collateral vessels were identified. MRI also showed parenchymal lesions in 48 (80%) hemispheres, and the extent of occlusion in the anterior and posterior circulations respectively correlated with white matter and cortical and/or subcortical infarcts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00588011
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  • 4
    Electronic Resource
    Electronic Resource
    Moyamoya disease: diagnostic accuracy of MRI (1995)
    Springer
    Neuroradiology 37 (1995), S. 356-361 
    Details
    ISSN: 1432-1920
    Keywords: Key words Moyamoya disease ; Magnetic resonance imaging ; Cerebral angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our purpose was to evaluate the diagnostic accuracy of MRI in moyamoya disease. We studied 30 patients with this disease, comparing MRI and angiographic findings. The diagnostic value of MRI was evaluated for occlusive lesions, collateral vessels, and parenchymal lesions. In all patients bilateral occlusion or stenosis of the supraclinoid internal carotid artery and proximal anterior and middle cerebral arteries was clearly shown by MRI, and staging of the extent of occlusion agreed with angiographic staging in 44 (73 %) of 60 arteries. MRI, particularly coronal images, clearly showed basal cerebral moyamoya vessels in 54 hemispheres, and 45 of a total of 71 large leptomeningeal and transdural collateral vessels were identified. MRI also showed parenchymal lesions in 48 (80 %) hemispheres, and the extent of occlusion in the anterior and posterior circulations respectively correlated with white matter and cortical and/or subcortical infarcts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00588011
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Anaerobic change of bloody CSF in subarachnoid haemorrhage. Its relation to cerebral vasospasm (1981)
    Springer
    Acta neurochirurgica 58 (1981), S. 15-26 
    Details
    ISSN: 0942-0940
    Keywords: Vasospasm ; CSF-blood incubation ; anaerobic incubation ; subarachnoid haemorrhage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In our in vitro study of subarachnoid haemorrhage, the anaerobic incubation of CSF-blood mixture led to marked fall in the pH value thereof, which suggested to us that intracranial focal acidosis may play some role in the pathogenesis of cerebral vasospasm or disturbance of consciousness after the haemorrhage. To test this hypothesis, we treated 16 clinical cases of such disorders with carotid injection of 7% sodium bicarbonate solution. The treatment resulted in considerable improvement of the disturbance of consciousness by dilating the cerebral peripheral arteries; this we could observe angiographically 15 minutes after carotid injection. We found no morphological changes, however, in the spastic vessel itself up to 30 minutes after the injection. Given the result both of this study and of our previous experiments, we offer the hypothesis that the synthesizing process of thromboxane A 2 and intracranial focal acidosis might play an important role in the pathogenesis of cerebral vasospasm.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01401680
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  • 6
    Electronic Resource
    Electronic Resource
    Changes of plasma thromboxane level in subarachnoid haemorrhage (1991)
    Springer
    Acta neurochirurgica 113 (1991), S. 166-170 
    Details
    ISSN: 0942-0940
    Keywords: 11-dehydro-TXB2 ; TXB2, 6-keto-1α ; subarachnoid haemorrhage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Changes of plasma thromboxane level in subarachnoid haemorrhage (SAH) were studied clinically and experimentally using 11-dehydro-thromboxane B2 (11 DTX) as a measuring index. 11 DTX is a major long-lived metabolite formed from thromboxane (TX) B2, and is said to be a more reliable parameter for detecting TXA2 production in biological systems. In this clinical study, blood was sampled from the cubital vein of 10 SAH patients on the earliest possible day (day 0 or 1), during the vasospasm predilection period (day 7∼11) and in the chronic stage (day 16∼32). Plasma concentrations of 11 DTX and 6-keto-1α were measured in clinical cases. A canine SAH model was produced by the two haemorrhage methods and blood was sampled from the superior sagittal sinus before and on day 4 of the first cisternal blood injection. 11 DTX, TXB2 and platelet function were examined in each sample. In the clinical studies, plasma 11 DTX levels tended to be higher in the early stage of SAH but decreased thereafter to the normal or lower level. Plasma concentrations of 6-keto-α tended to decrease mildly during the vasospasm predilection period. In the experimental study, neither definite change of plasma 11 DTX level nor neurological deficit could be induced by the mimic SAH, while an increase in platelet aggregability and narrowing of the basilar artery were observed. 11 DTX was inferred to be a more reliable parameter of TX biosynthesis than TXB2.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01403202
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  • 7
    Electronic Resource
    Electronic Resource
    Subarachnoid haemorrhage and communicating hydrocephalus scanning electron microscopic observations (1979)
    Springer
    Acta neurochirurgica 50 (1979), S. 265-272 
    Details
    ISSN: 0942-0940
    Keywords: Electron microscope ; subarachnoid haemorrhage ; hydrocephalus ; subarachnoid fibrosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Scanning electron microscopic changes in the subarachnoid space after subarachnoid haemorrhage are described. The obstructive changes were classified into five grades ranging from patency to total obstruction. We report a correlation between communicating hydrocephalus and obstruction above grade 3 in the parasagittal region (p 〈 0.01) and the lateral cerebral fissure (p 〈 0.05).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01808523
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  • 8
    Electronic Resource
    Electronic Resource
    Prevention of cerebral vasospasm with OKY-046 an imidazole derivative and a thromboxane synthetase inhibitor. A preliminary co-operative clinical study (1985)
    Springer
    Acta neurochirurgica 77 (1985), S. 133-141 
    Details
    ISSN: 0942-0940
    Keywords: Cerebral vasospasm ; subarachnoid haemorrhage ; thromboxane A2 ; TXA2 synthetase inhibitor ; OKY-046
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The prevention of cerebral vasospasm with OKY-046, an imidazole derivative and a thromboxane synthetase inhibitor, was studied co-operatively at ten neurosurgical services. Intravenous administrations of 2, 5 or 10 μ/kg/minute of OKY-046 were given continuously from the earliest possible day to the 14th SAH-day to 82 pateints with ruptured cerebral aneurysm. Sixty-eight patients (83%) showed moderate to high high-density (SAH) in their initial CTs. Angiographic vasospasms were seen in 58 patients, representing 71% of all cases or 81% of the 72 cases for which angiograms were available; the vasospasms of 45 patients (55 or 63%) were moderate to severe. Symptomatic vasospasm occurred, however, only in 27 patients (33%); in 18 of those cases, moreover, the symptoms were mild or transient. The conditions of the patients at one month after the SAH were classified into 9 grades from 0 (normal) to 8 (deceased). Fifty-two patients (63%) were classified as 0 or 1, and 64 (78%) as better than 3 (possible daily life unaided). The administration of OKY-046 was proven to decrease TXB2 in the blood. This paper emphasizes the effectiveness of the drug for symptomatic vasospasm, and supports our previous contention that cerebral microthrombosis may play an important role in the pathogenesis of cerebral vasospasm.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01476216
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