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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS); 20160612-20160615; Frankfurt am Main; DOCDI.11.06 /20160608/
    Publication Date: 2016-06-17
    Keywords: decompressive craniectomy ; traumatic brain injury ; children ; ddc: 610
    Language: English
    Type: conferenceObject
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC); 20130526-20130529; Düsseldorf; DOCMO.08.04 /20130521/
    Publication Date: 2013-05-22
    Keywords: minimally-invasive ; neurosurgical simulation ; 3D virtual reality ; ddc: 610
    Language: English
    Type: conferenceObject
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Child's nervous system 16 (2000), S. 835-836 
    ISSN: 1433-0350
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 0942-0940
    Keywords: Intraventricular aneurysm ; surgical anatomy ; transcallosal approach
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In lesions located in the lateral ventricle of the dominant hemisphere the contralateral transcallosal approach provides maximum protection of the dominant side as well as excellent visualization of the cella media of the contralateral lateral ventricle. We demonstrated this safe approach in a rare case with intraventricular aneurysm of the left medial choroid artery. The literature on aneurysms in the lateral ventricle is discussed.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 0942-0940
    Keywords: Stereotactic biopsy ; Doppler techniques ; cerebral vessels
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The use of a 20 MHz pulsed Doppler technique during stereotactic brain tumour biopsies is described. By means of a miniaturized ultrasonic probe the tissue planned for biopsy was investigated for vessel signals. Out of 41 patients, with this technique a flow-pulse curve in front of the biopsy cannula was registered in 14 cases. In 9 cases one pulse curve was determined and in 5 cases two or more flow curves were found, indicating the presence of arterial vessels. The depth of the vesses signal could be localized and this area avoided for biopsy sampling. In a series of 41 Stereotactic biopsies carried out in this way there was no intra-operative haemorrhage or postoperative haematoma.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 0942-0940
    Keywords: Keywords: Stereotactic radiosurgery; meningioma; skull base; brain tumour.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Background. The standart surgical treatment of meningiomas is total resection of the tumour. The complete removal of skull base meningiomas can be difficult because of the proximity of cranial nerves. Stereotactic radiosurgery (SRS) is an effective therapy, either for adjuvant treatment in case of subtotal or partial tumour resection, or as solitary treatment in asymptomatic meningiomas.  Method. Between September 1992 and October 1995, SRS using the Leksell Gamma Knife was performed on 46 patients (f:m=35:15), ranging in age from 35 to 81 years, with skull base meningiomas at the Neurosurgical Department of the University of Vienna. According to the indication of gamma knife radiosurgery (GKRS) the patients (n=46) were devided into two subgroups. Group I (combined procedure: subtotal resection followed by GKRS as a planned procedure or because of a recurrent meningioma), group II (GKRS as the primary treatment). Histological examination of tumour tissue was available for 31 patients (67%) after surgery covering 25 benign (81%) and 6 malignant (19%) meningioma subtypes.  Findings. The overall tumour control rate after a mean follow-up period of 48 months (ranging from 36 to 76 months) was 96% (97.5% in benign and 83% in malignant meningiomas). Group I displayed a 96.7% tumour control rate, followed by group II with 93.3% respectively. Neurological follow-up showed an improvement in 33%, stable clinical course in 58% and a persistant deterioration of clinical symtoms in 9%. Remarkable neurological improvement after GKRS was observed in group II (47%), whereas in group I (26%) the amelioration of symptoms was less pronounced.  Interpretation. GKRS in meningiomas is a safe and effective treatment. A good tumour control and low morbidity rate was achieved in both groups (I, II) of our series, either as a primary or adjunctive therapeutic approach. The planned combination of microsurgery and GKRS extends the therapeutic spectrum in the treatment of meningiomas. Reduction of tumour volume, increasing the distance to the optical pathways and the knowledge of the actual growing tendency by histological evaluation of the tumour minimises the risk of morbidity and local regrowth. Small and sharply demarcated tumours are in general ideal candidates for single high dose-GKRS, even after failed surgery and radiation therapy, and in special cases also in larger tumour sizes with an adapted/reduced margine dose.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 0942-0940
    Keywords: Keywords: Brain metastasis; stereotactic radiosurgery; surgery.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Stereotactic radiosurgery (RS) and surgery have proved to be effective treatment modalities for brain metastasis. We followed 133 patients whose treatment for intracranial disease was either RS or a single surgical resection at the University of Vienna from August 1992 through October 1996. All patients who received additional Whole Brain Radiotherapy were included. This was a retrospective, case-control study comparing these treatment modalities.  Sixty-seven patients were treated by RS and 66 patients were treated by microsurgery. The median size of the treated lesions for RS patients was 7800 mm3, and 12500 mm3 for microsurgery patients, respectively. The median dose delivered to the tumour margin for RS patients was 17 gray.  The median survival for patients after RS was 12 months, and 9 months for patients after microsurgery. This difference was not statistically significant (p=0.19). Comparison of local tumour control, defined as absence of regrowth of a treated lesion, showed that tumours following RS had a preferred local control rate (p〈0.05). Univariate and multivariate analysis showed that this fact was due to a greater response rate of “radioresistant” metastasis to RS (p〈0.005). Postradiosurgical complications included the onset of peritumoural oedema (n=5) and radiation necrosis (n=1). Two patients after microsurgery experienced local wound infection. One postoperative death occurred due to pulmonary embolism in this group.  On the basis of our data we conclude that RS and microsurgery combined with Whole Brain Radiotherapy are comparable modalities in treating single brain metastasis. Concerning morbidity and local tumour control, in particular in cases of “radioresistant” primary tumours, RS is superior. Therefore we advocate RS except for cases of large tumours (〉3 cm in maximum diameter) and for those with mass effect.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 0942-0940
    Keywords: Age ; Doppler velocimetry ; subarachnoid haemorrhage ; vasospasm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A retrospective analysis was undertaken to determine whether cerebral vasospasm following subarachnoid haemorrhage (SAH) correlates with the age of patients. For at least 3 weeks after bleeding 80 subjects underwent very close follow-up with clinical examination and transcranial Doppler records of the blood velocities within the basal cerebral arteries. Firstly a correlation between measured maximal mean blood flow velocities and age was made. Secondly, according to their age and the maximum of recorded mean velocitites (v), the patients were divided into groups as follows: age 55 years or less, age more than 55 years; and maximum velocity v1〈90cm/s, 90cm/s〈v2〈120cm/s, 120cm/s〈v3〈160cm/s, v4〉160cm/s. There was a significant correlation of the measured maximum mean velocities and the age of the patients (r =−0.525, p〈0.01). With regard to the velocity groups there was a significant (chisquared statistic for contingency tables, p〈0.01) difference between both age-groups: 32% (n=18) of the younger fell into group v4 with maximum mean velocities of more than 160cm/s, but none of the older had such. Vice versa, 63% (n=15) of the older compared with only 14% (n=8) of the younger fell into group v1 with maximum mean velocities of less than 90 cm/s. Clinical follow-up also depicted differences between both age groups. 13 of 18 younger patients with maximum mean velocities 〉160 cm/s exhibited symptomatic vasospasm with a delayed neurological deficit. This typical course did not occur in the older age group. We conclude from this analysis that the increase of blood velocity in the basal cerebral arteries following subarachnoid haemorrhage depends on the age of the patient. Furthermore, young patients will be more prone to a delayed ischaemic deficit. On the other hand, older patients may also suffer ischaemic deficits following subarachnoid haemorrhage but often without measurable vasospasm according to transcranial Doppler criteria and without the typical delayed appearance.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 241 (1994), S. 350-351 
    ISSN: 1432-1459
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Neurosurgical review 16 (1993), S. 333-336 
    ISSN: 1437-2320
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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