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  • 1
    ISSN: 0942-0940
    Keywords: Head injury ; outcome ; Glasgow Coma Scale ; children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Patients defined as having a moderate head injury on the basis of Glasgow Coma Scale scores within the ranges of 9 to 13 after acute nonsurgical procedures were selected. Almost 1600 cases were hospitalized in the Neurosurgery Department. The cases were admitted through the Emergency Unit of Gaz University Medical School, Ankara, Turkey during the period between 1979 and 1992. The group studied consisted of 231 selected patients assessed separately in paediatric, adult and elderly age groups. Possible risk factors such as: GCS score, anisocoria, unilateral or bilateral fixed pupils, impaired oculocephalic reflexes, presence of multiple systemic injuries, aetiology of head trauma, presence of linear or depressed skull fractures, space occupying mass on CT or operation was also assessed. Subarachnoid haemorrhage turned out to be the only independent significant risk factor in predicting mortality. The data about the patients who have “talked and deteriorated” were also reported so as to assisst physicians charged with the care of trauma victims.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0942-0940
    Keywords: Endothelium derived relaxation factor ; aneurysm clip ; manipulations ; microvascular clip
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Mechanically induced vasoconstriction observed throughout surgery and in the immediate postoperative period was investigated to assess the effects of various microsurgical manipulations. Factors such as the type of aneurysm clip, duration of temporary clipping and peri-adventitial tissue stripping were the variables in this study. Microsurgical clips were applied on guinea pig “cervical carotid arteries” in which peri-adventitia had been removed microsurgically. Arterial rings were removed immediately after surgery. Endothelium dependent relaxations were measured and morphological investigations were performed using light microscopy. It was observed that as the clip application period increased, relaxation responses decreased. Peri-adventitial tissue stripping caused a marked decrease in the relaxation responses in all types of the clips. Microvascular clips, in spite of their lower closing forces, had the greatest deleterious effect on relaxation responses of the vessel, in both normal and peri-adventitial tissue stripped. When the peri-adventitial tissue of the vessel had been stripped, convolutions of the lamina elastica interna were found to be lost in parallel with the decreased tonus of the artery. In the vessels subjected to clipping endothelial denudation and cracking took place. As a conclusion it can be stated that both peri-adventitial tissue stripping and microvascular clip application have deleterious effects in the early postoperative period. While choosing clips from minimal occlusion force tables, care must be taken to choose clips with less width; and while performing microvascular anastomosis, temporary clips with a lesser width must be used in place of microvascular clips. Adventitial stripping must not be unnecessarily generous during microvascular anastomosis.
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 131 (1994), S. 211-214 
    ISSN: 0942-0940
    Keywords: White blood cell count ; leucocytosis ; head trauma ; prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A prospective analysis of 153 cases of head trauma was conducted with respect to their white blood cell counts. A white blood cell count exceeding 20×106/l is associated with a poor clinical grade on admission and with a 96% mortality as opposed to that of a 23% mortality for those with slightly lower or slightly above normal white blood cell count. The sensitivity for this level is a mortality of 96% while the specificity is 77%.
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  • 4
    ISSN: 0942-0940
    Keywords: Cerebral vasospasm ; basilar artery ; endothelin-1 ; ultrastructure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In this study intra-arterial Endothelin-1 was applied to rabbit basilar arteries and morphological findings were compared between two groups who were either perfusion fixed or immersion fixed. We planned to establish the quantitative dimension of the drug-induced morphological alterations, independent of the fixation technique's effect. There was an abundance of collagenous fibres deposited among the smooth muscle cells which was not observed in control arteries and after immersion fixation. These degenerative changes are similar to the finding following subarachnoid haemorrhage. The only fixation-related difference was the fact that lamina elastica interna was not corrugated in the perfusion fixation group. It is concluded that, the observed changes in the connective tissue of the arterial wall alter the passive elastic properties and so affect the degree of the response to the vasoactive messengers.
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  • 5
    ISSN: 0942-0940
    Keywords: Cerebral vasospasm ; basilar artery ; cerebral angiography ; subarachnoid haemorrhage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We describe a new computer-based, automated method for the assessment of in vivo cerebral vasospasm. Arterial diameter measurements were performed on post-processed digital substraction angiographic images, using “pixel” as the unit. Vasospasm which was difficult to detect by visual inspection could be measured by the “stenosis quantification” program. A computer-assisted method such as we describe might decrease the risk of subjective errors.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 140 (1998), S. 619-620 
    ISSN: 0942-0940
    Keywords: Keywords: Bipolar coagulator; instrumentation; neurosurgical operations.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Background. Sometimes charring or popping occurs and the bipolar blades get stuck to the vessel.  Methods. The tips of one of the many commercially available bipolar forceps were coated in a striped manner with Teflon −50 μ in thickness.  Results. The new bipolar coagulator coated with Teflon reduced the incidence of tissue sticking.  Conclusions. Experience with this instrument was still quite limited, but preliminary results were promising.
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  • 7
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Brucella-Infektion führt nur selten zu einem Befall des Zentralnervensystems. Wir berichten über einen Patienten mit progressiver spastischer Paraparese, bei dem medikamentöse und chirurgische Maßnahmen erfolgten. Die Symptomatik beruhte auf einer Rückenmarkskompression im Thorakalbereich durch ein Brucella-Granulom. Es bestanden keinerlei Symptome einer systemischen Brucella-Infektion.
    Notes: Summary Central Nervous System (CNS) involvement during the course of Brucella infection is a rare clinical condition. In this article, a patient with a progressive paraparesis syndrome with spasticity, who was treated by medical methods and surgical intervention is analysed. This patient suffered from spinal cord compression in the thoracal region caused by a Brucella granuloma. The patient had no evidence of systemic Brucella infection.
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  • 8
    ISSN: 1432-1920
    Keywords: Computed tomography ; Contrast medium ; Computed tomographic ventriculography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present 31 patients whose diagnoses were established by the aid of computed tomographic ventriculography. The indications for and diagnostic value of this method are reviewed.
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