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  • 11
    Electronic Resource
    Electronic Resource
    Springer
    Acta neuropathologica 53 (1981), S. 145-153 
    ISSN: 1432-0533
    Keywords: Central pontine myelinolysis ; Electrolyte disturbances ; Acid-base imbalance ; Extrapontine myelinolysis ; Oligodendrocyte ; Myelin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Thirty-seven cases of central pontine myelinolysis (CPM) with miscellaneous underlying disorders were found in 1,000 consecutive autopsies, of which 636 brains were examined. The incidence of CPM in this study was 5.8%. The frequent underlying disorders were malignant neoplasms (43%), chronic pulmonary disease (27%), and chronic renal failure cases under dialysis treatment (14%). Fatty liver cirrhosis due to alcohol abuse was recognized in only one CPM case. In the present study, 78% of the CPM cases revealed either electrolyte disturbances or abnormal blood gas data, such as marked deviation of base excess and/or of serum pH in 62.5%, hyper- or hypochloremia (above 115 mEq/l, below 95 mEq/l) in 47%, hyper- or hyponatremia (above 150 mEq/l, below 130 mEq/l) in 25%, marked hypoxemia (less than 40 mmHg) in 12.5% and hypokalemia (below 3.0 mEq/l) in 9% of the CPM cases. The myelinolytic changes were localized in the basis pontis in 14 of 37 CPM cases and in the basis pontis and the cerebral and/or cerebellar white matter (extrapontine myelinolysis) in the remaining 23 cases. The extrapontine changes were also closely related to the electrolyte disturbances or the abnormal blood gas data. The results of this study suggest that myclin and oligodendrocytes in the basis pontis and cerebral and cerebellar white matter are vulnerable to abnormal levels of serum electrolytes and also to marked changes of the acid-base balance.
    Type of Medium: Electronic Resource
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  • 12
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 132 (1979), S. 11-16 
    ISSN: 1432-1076
    Keywords: Poliomyelitis ; Agammaglobulinemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This paper gives the clinical, immunological and virological data on a patient with agammaglobulinemia who developed paralytic poliomyelitis. The patient was a 3 year-old boy who had a typical B-cell defect without a T-cell defect. He had profound hypogammaglobulinemia and defective plasma cells and had repeated pyogenic infections which were controlled by gammaglobulin replacement therapy. At 3 years of age, he was admitted to our hospital with suspected meningitis. He had fever, tremor and neck stiffness for 3 days and subsequently developed paralysis in his left arm and right leg. There was lymphocytosis in the cerebrospinal fluid. A non vaccine-like strain of poliovirus type 2 was isolated from the stool.
    Type of Medium: Electronic Resource
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  • 13
    ISSN: 1432-1076
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 14
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 136 (1995), S. 29-36 
    ISSN: 0942-0940
    Keywords: Cavernous malformation ; optic chiasma ; magnetic resonance imaging ; surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Two cases of cavernous malformation of the optic chiasm are reported, and 12 previously reported cases are reviewed. The first patient presented with gradually progressive and the second patient with a subacute chiasmal syndrome. Total excision was performed in both cases. Visual function improved slightly after surgery in the first patient while the other showed marked improvement. Although cavernous malformations are angiographically occult, pre-operative diagnosis has become possible based on the characteristic features such as repeated haemorrhages in multiple sinusoidal structures as revealed by magnetic resonance imaging (MRI). A gliotic interspace between the malformation and normal neural tissue provides a plane of cleavage for dissection which permits total excision without causing new deficits. Review of previously reported cases revealed that chiasmal cavernous malformations haemorrhage more frequently than those in the brain. Early diagnosis with total excision is the treatment of choice for cavernous malformations of the optic chiasma.
    Type of Medium: Electronic Resource
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  • 15
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 36 (1977), S. 111-115 
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A rare case of dural haemangioma with extracranial component is described. A subcutaneous frontal tumour was thought before operation to have originated in the skull. Angiography showed drainage into the superior sagittal sinus via a cortical vein. Dural haemangioma is thought to be a clinical rarity. Also, an arteriovenous malformation draining into the superior sagittal sinus is rarely encountered.
    Type of Medium: Electronic Resource
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  • 16
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 59 (1981), S. 79-86 
    ISSN: 0942-0940
    Keywords: Moyamoya phenomenon ; carotide artery occlusion ; intracranial vasospasm ; subarachnoid haemorrhage ; ruptured intracranial aneurysm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Both the Moyamoya Phenomenon and occlusion of the internal carotid fork are essential radiological findings in true Moyamoya Disease of unknown aetiology. However, the Moyamoya Phenomenon is often observed in occlusive diseases of the internal carotid bifurcation of known aetiology. The authors recently observed acute development of the unilateral Moyamoya Phenomenon following severe vasospasm of the anterior and middle cerebral arteries due to rupture of an anterior communicating aneurysm. The following four factors have been suspected of contributing to development of the Moyamoya Phenomenon: 1. The chronology of arterial occlusion. 2. Extent and location of occlusion. 3. The cause of occlusion. 4. Anatomical and functional disposition of the basal circulation. As regards the chronology, chronic or slowly progressive arterial stenosis has been thought to be a mandatory factor in development of a Moyamoya network, which plays an important role in the form of collateral channels. However, based on the findings outlined in this paper, the congenital factor may be the most important of the four factors.
    Type of Medium: Electronic Resource
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  • 17
    ISSN: 0942-0940
    Keywords: Keywords: Collateral circulation; intracranial-extracranial bypass surgery; moyamoya disease; nitric oxide.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Background. To investigate whether nitric oxide (NO) contributes to formation of abnormal collateral circulation in patients with moyamoya disease.  Methods. Cerebrospinal fluid (CSF) samples were obtained from the subarachnoid space of the Sylvian fissure during combined bypass surgery for moyamoya disease and kept frozen until NO metabolites, nitrate and nitrite, were measured using a Griess method.  Results. Compared with control CSF obtained from 18 patients with hemifacial spasm, unruptured aneurysm, etc., concentrations of NO metabolites in 26 CSF samples of 18 patients with moyamoya disease were significantly higher (mean±SE; 17.6±1.2 vs. 10.5±1.0 μM, p〈0.01). In eight patients, the CSF samples from both the first and second operation could be obtained. NO metabolite concentrations (20.5±2.3 μM) in CSF obtained from the first surgery decreased to 15.7±1.8 μM (p〈0.01) in CSF obtained from the second, contralateral procedure. The cases of moyamoya disease with greater development of moyamoya vessels at angiographic stage 3 and 4 tended to show higher concentrations of NO metabolites than cases at earlier or later stages with a few moyamoya vessels.  Interpretation. Nitric oxide concentrations in CSF are chronically elevated in moyamoya disease, probably reflecting development of abnormal collateral circulation. i.e. moyamoya vessels. Vascular bypass surgery can reduce abnormal collateral circulation with reduced production of nitric oxide.
    Type of Medium: Electronic Resource
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  • 18
    ISSN: 0942-0940
    Keywords: Keywords: Anterior cervical fusion; bone graft; spondylosis; vertebral body.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  A retrospective analysis was done in 60 consecutive patients who underwent anterior cervical fusion using vertebral grafts obtained from the fusion site at the Nagoya University and its affiliated hospitals by a single surgeon (MT). Follow-up results and technical advantages are reported. The average follow-up period was 33 months (range 6 to 55 months). Sufficient decompression of the anterior cervical pathology was performed successfully via a wider operative field. The symptoms and neurological score improved significantly without any new deficits in all patients except in one with a three-level fusion who needed re-operation for further decompression. No major graft complications such as graft extrusion or pseudoarthrosis occurred. Graft fracture was noted in five cases. However, good bony fusion was observed in all these cases without any further treatment. Normal cervical lordosis was preserved in most cases except in four, who lost lordotic alignment but did not show kyphosis. Major advantages of this method are a wider operative field, excellent graft fusion rate, and no need for an additional incision to obtain autogenous bone graft.  These benefits seem have to contributed to satisfactory surgical results in this series.
    Type of Medium: Electronic Resource
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  • 19
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 53 (1980), S. 141-149 
    ISSN: 0942-0940
    Keywords: Laser surgery ; brain tumours ; operative technique
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A surgical carbon dioxide laser unit (laser) has been used since 1977 in twentyfive cases of various brain tumours, including ten meningiomas (four sphenoid ridge, two parasagittal, two falx, one olfactory, one posterior fossa), eleven gliomas (seven glioblastoma, four astrocytoma), two metastatic brain tumours, one haemangioblastoma, and one arteriovenous malformation (AVM). The criteria for laser use, as based on evaluation and location of meningioma, were: grade 1, convenient but adjuvant; grade 2, also necessary; grade 3, indispensable. The laser is obligatory in sphenoid ridge meningioma in order to peel the tumour away from the internal carotid artery, middle cerebral artery, cavernous sinus etc. The grade of necessity for laser use is therefore either 2 or 3. In convexity or parasagittal meningioma, on the other hand, the necessity grade is either 1 or 2. In the glioma group hemorrhage in seven cases of glioblastoma was easily laser-controlled, and the tumours were wasted away in a short time through vaporization, with minimum mechanical effect on adjacent tissue. The laser is therefore very useful in cases of glioma, especially glioblastoma, considering the shortened operating time, decreased blood loss, and extended area of tumour resection. Laser surgery is proposed as being most appropriate, mainly for its vaporizing and coagulating functions, in cases of brain tumour involving the elderly and poor risk cases.
    Type of Medium: Electronic Resource
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  • 20
    ISSN: 0942-0940
    Keywords: Homovanillic acid (HVA ; 5-hydroxyindoleacetic acid (5-HIAA) ; Tryptophan (TRP) ; subarachnoid haemorrhage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA) and tryptophan (TRP) were measured in the CSF obtained from the basal cistern of 20 patients, who had undergone surgical obliteration of bleeding aneurysms within 3 days after subarachnoid haemorrhage (SAH). The concentrations of these substances, which were assayed by high performance liquid chromatography (HPLC), were the highest on days 3 or 4, and thereafter showed a gradual decrease with an increase in time. The cisternal CSF in patients who had severe pre-operative clinical grades of SAH or vasospasm contained relatively higher concentrations of HVA, 5-HIAA and TRP than those contained in patients who did not. It is proposed that SAH stimulates the release of monoamines from the brain with the resultant extracellular accumulation of their metabolites and their diffusion into CSF during the acute stage. This stimulatory effect of SAH on the brain monoamine system may be consistent with those previously reported in cases of cerebral haemorrhage or infarction.
    Type of Medium: Electronic Resource
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