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  • 1
    ISSN: 1433-0350
    Keywords: Key words Callosotomy ; Corpus callosum ; Lennox-Gastaut syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  From September 1989 to August 1996, we performed anterior corpus callosotomy in 83 patients. Unfortunately, 9 patients were lost to follow-up. Among the remaining 74 patients, 59 had Lennox-Gastaut syndrome (evolved from infantile spasms in 22), 9 had complex partial seizures with or without secondary generalized seizures, 1 had multifocal independent epileptogenic foci (MISF) syndrome, 3 had hemiconvulsion-hemiplegia-epilepsy (HHE), and 2 had infantile spasms. All cases were followed up for at least 2 years after surgery. The highest rate of significant improvement (more than 50% reduction in seizure frequency) was noted in the patients with generalized tonic-clonic seizures, 82.1% of whom experienced significant improvement, followed by those with generalized tonic seizures (76.7%), atonic seizures (72.7%), myoclonic seizures (64.9%), atypical absences (58.6%), and complex partial seizure with or without secondary generalization (61.5%). Complete freedom from seizures was noted in 14 cases (18.9%). One patient had the anterior half of his right palm amputated following radial artery thrombosis complicated by insertion of an arterial line during anesthesia. Otherwise, there were no major postoperative complications except for brief mutism and multifocal jerks in some patients during the 1st postoperative week. Thus, we conclude that corpus callosotomy is a safe alternative treatment for all kinds of medically intractable seizures, especially generalized epilepsy.
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  • 2
    ISSN: 0942-0940
    Keywords: Cerebral arteriovenous malformation ; radiosurgery ; risk of further haemorrhage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A case with an ill-defined arteriovenous malformation in the parieto-occipital region is presented. Open surgery was unsuccessful in removing the AVM totally, and treatment with gamma knife radiosurgery was then attempted. At 14 months after this treatment the AVM was believed to be obliterated. The patient had a new intracranial haemorrhage 59 months after radiosurgery. Renewed angiography showed an obvious AVM outside the previously irradiated area. Retrospective analysis of the angiogram at 14 months after radiosurgery revealed early filling of a draining vein as a sign of residual AVM at this time. Renewed radiosurgical treatment was performed. It is believed that an ill-defined margin, laminar flow, and effects of previous surgery might add to difficulties in a proper visualisation and delineation of an AVM. Further, a small remaining shunt may be overlooked if the angiogram is not carefully analysed or if the angiogram is of inferior quality. It should be stressed that partial or almost total obliteration of an AVM is no protection against rebleeding.
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  • 3
    ISSN: 1432-2072
    Keywords: Antidepressants ; Quinine ; Forced swimming test ; Potassium channel blocker ; Mice
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to investigate if quinine plus antidepressant drugs (ADS) leads to an additive effect in the forced swimming test. Quinine (0.125, 0.5 mg/kg) and ADS (subactive doses) were given IP 45 and 30 min, respectively, before the test. When combined with QUIN, all drugs that act via inhibition of 5-HT uptake (imipramine, amitriptyline, citalopram, paroxetine, fluoxetine and fluvoxamine) significantly increased the swimming time of mice. Among trazodone, mianserin and iprindole (atypical ADS), only iprindole combined with quinine decreased the immobility (increased swimming) of the animals. The specific noradrenaline (NA) uptake inhibitors, desipramine and viloxazine, but not maprotiline, were also found to reduce the immobility time when pretreated with quinine. The mixed monoamine oxidase (MAO) inhibitor (pargyline) and MAO-A inhibitor (moclobemide) also shortened the period of immobility whereas the MAO-B inhibitor (nialamide) and the dopamine (DA) uptake inhibitor (bupropion) did not. Quinine's additive effects on several types of ADS is likely a result of blockade of potassium channels.
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  • 4
    ISSN: 1432-1920
    Keywords: AVM ; Stereotaxic irradiation ; Angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Multiple intracranial arteriovenous malformations are rare. There are a few cases in the literature with up to three malformations in one patient. A child with seven separate cerebral malformations is now described. There was no history of haemorrhage, but only of febrile seizures. The malformations were discovered at CT and verified at angiography. Six were selected for stereotaxic irradiation with the multicobalt unit. The seventh was considered too big for irradiation and suitable for surgery.
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  • 5
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    Neuroradiology 31 (1990), S. 498-501 
    ISSN: 1432-1920
    Keywords: Polymorphic reticulosis ; Lymphomatoid granulomatosis ; CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary For the understanding of the CT findings of polymorphic reticulosis involving the upper respiratory tract, we reviewed eleven cases of this disease with initial CT study before treatment. CT revealed masses or swelling in the nose or nasal chamber, often with involvement of paranasal sinuses and medial parts of the orbit. In some, nonspecific minimal bony change (either bone destruction or bone sclerosis) was found. These CT findings are not specific. Any large mass in the nose and nasal fossa with little associated bone destruction should, however, raise the differential diagnosis of polymorphic reticulosis.
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  • 6
    ISSN: 1432-1920
    Keywords: Vertebral arteriovenous fistula ; Embolization ; Endovascular occlusion ; Detachable balloon ; CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We report a case of vertebral arteriovenous fistula, in which embolization was complicated by migration of two coils and a partially inflated balloon. In order to relieve compression to the spinal cord, the displaced balloon was punctured percutaneously. For both relieving compression to the spinal cord and obliterating the residual fistula, the dislodged coils in the partially thrombosed epidural venous sinus were removed percutaneously and placed in the fistula, and more coils were implanted in the fistula percutaneously through the needle. CT follow-up half a year later showed complete resolution of compression of the spinal cord and complete recovery from myelopathy was clinically apparent.
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  • 7
    ISSN: 1432-1920
    Keywords: Pituitary tumour ; Haemorrhage ; Magnetic resonance imaging ; Bromocriptine medication
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a group of 69 patients with pituitary tumours, 12 were found to have evidence of intratumoral haemorrhage on MRI, characterized by high signal intensity on short TR/TE sequences. This was verified in all but 1 patient. The majority of the bleedings occurred in macroadenomas. Five (42%) were prolactinomas and 4 (33%) were non-functioning adenomas. There were 2 GH- and 1 ACTH-secreting tumours. All 5 patients with prolactinomas were on bromocriptine medication. Two of the patients had a clinical picture of pituitary apoplexy. The haemorrhage was not large enough to prompt surgery in any of the patients. However, surgical verification of the diagnosis was obtained in 5 cases, while 6 patients were examined with follow-up MRI.
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