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Biomedical subjects

B Danilewicz

Publications and source records attributed to B Danilewicz.

At least 19 recordsLinked to original sources
PubMed2001

Dysembryoplastic neuroepithelial tumour (DNT). Is the mechanism of seizures related to glutamate? An immunohistochemical study.

Dysembryoplastic neuroepithelial tumour (DNT) is a rare low-grade, mixed neuronal and glial tumour, usually associated with pharmacologically intractable, complex partial or generalised seizures which date from childhood. The prognosis after surgery is favourable. We present a classic case of DNT occurring in an 18-year-old male, who presented simple partial seizures without signs of raised intracranial pressure. CT and MR demonstrated focal mass located in the right temporal lobe. Histologically there were found the features of a typical DNT architecture with mixed cellular composition. The response to surgery was excellent. The tumour has not recurred, and the control of seizures remained good. Immunostaining for glutamate receptor GluR-2 showed stronger immunopositivity in neurones dispersed within the tumour and especially in margins of lesion as compared with apparently normal cerebral cortex. The expression of both excitatoryamino acid transporterproteins EAAT1 and EAAT2 was weaker then in normal cortex and uneven. This perhaps may explain the mechanism of seizures (elevated glutaminergic stimulation), and may suggest the excitotoxic damage of neurones.

Adult↗
PubMed2001

[Pituitary function after transsphenoidal surgery for pituitary adenoma].

Nowadays transsphenoidal surgery is the method of choice in most cases of pituitary adenoma treatment, both functioning and non-functioning. This method is considered to be safer than transcranial approach, as lower incidence of complications, particularly hypopituitarism, is observed. The aim of the study was to evaluate the pituitary function after transsphenoidal surgery. 20 patients (mean age 49.3 +/- 13.9 years) were included into the study. The anterior pituitary insufficiency was defined as an inadequate excretory response to metopirone, LH-RH and TRH stimulation. Diabetes insipidus was diagnosed based on clinical symptoms. Hypopituitarism was diagnosed after surgery in 7 patients, 3 cases had adrenal and gonadal insufficiency, 1 patient had insufficiency of the pituitary-thyroid and gonadal axis and 3 subjects panhypopituitarism. Diabetes insipidus was still present in 2 patients, 3 months after surgery. We conclude that transsphenoidal approach in pituitary adenoma surgery is connected with low risk of iatrogenic hypopituitarism.

Adenoma↗
PubMed2000

[Intradural clivus chordoma: surgical treatment with no tumor regrowth 12 years after surgery].

We present a case of a 19-year-old woman treated in the Neurosurgery Department of Collegium Medicum of the Jagiellonian University in Kraków because of the clival chordoma. The patient with one year anamnesis, treated surgically and then rehabilitated, was examined 12 years after she left our department. Radiologically we did not find tumor regrowth. We only found diplopia, but this sign was present from the time of the operation. Such a long time of katamnesis proves possibility of total removal in this type of tumors.

Adult↗
PubMed2000

[Risk factors for surgical treatment of supratentorial cerebral arterio-venous angiomas].

The authors present the influence of the selected risk factors in surgical treatment of supratentorial cerebral arterio-venous angiomas. The material represents 38 patients treated in the Neurosurgical Department Collegium Medicum of the Jagiellonian University in the last decade. In 28 of the patients the first sign of angioma was subarachnoid haemorrhage (SAH) and the remaining 10 were revealed with seizures. The assessment of the patients when admitted to the Department was graded using the WFNS scale. The diagnosis was established based on clinical symptoms, the results of computerized tomography and cerebral angiography. The extent of the SAH was graded by the Fisher's scale. The detected angiomas were classified according to the Spetzler scale. All patients were operated on using the microsurgical technique. After occluding the feeding arteries, a selective excision was made into the angiomas and the pathological cerebral tissue. The radical of the operation was controlled by cerebral angiography. The results of the surgical treatment were graded by the modified "outcome" Spetzler scale. The following risk factors were analysed: age, WFNS grade, Fisher's grade and Spetzler's grade. The statistical calculations were made using the chi square test and the Mann-Whitney U-test (p < 0.05). In 7 of the patients the results were very good (18.4%), in 12 the results were good (31.6%), and in 14 the results were bad (36.8%). Five of the patients died (13.2%). There was no statistically significant relationship between the risk factors and the results of treatment of supratentorial cerebral arterio-venous angiomas. In the percentage analysis, the best results were obtained from young patients without SAH and with superficial pattern of venous drainage.

Adolescent↗
PubMed1999

[The influence of shunt surgery on the improvement of cognitive disorders in hydrocephalic patients].

We present 43 cases with cognitive disorders due to communicating hydrocephalus assessed by means of neuropshychological tests before and 4-8 months after shunt treatment. The patients were the part of the 95 hydrocephalic cases (45.3%) operated on in the period of 1993-98 at the Department of Neurosurgery in Kraków. Cognitive functions improvement was detected in 81.4% cases, no changes in 7%, and deterioration in 11.6%. Most often the improvement of lingual function, short memory and attention was noted. The worst prognosis for the prediction of improvement of the cognitive functions had the patients with significant cerebral atrophy, and those with symptoms lasting over 1 years.

Adult↗
PubMed1999

[Early results of treating pituitary adenomas by means of transcranial and trans-phenoidal approach].

Among the methods of the surgical approach to the pituitary tumours, transsphenoidal (TS) route replaced transcranial (TC) route in the majority of patients. The authors present the development of the surgical treatment of pituitary tumours, and present the early results of treatment by means of both methods of surgery based on the experience of the Department of Neurosurgery in Kraków. Consecutive 45 cases of pituitary adenomas treated by means of TC route (1989-1998)--I group, were compared to 57 cases operated on by means of TS approach (1996-1999)--II group. The other tumours and re-operated patients were excluded from the study. The following factors were compared: the size of treated tumours, the radicality of tumour excision (subtotal, partial), the presence of the massive hypothalamic dysfunction, the presence of diabetes insipidus, changes in visual field, early results of treatment (good, bad, surgical deaths). Using transsphenoidal approach significantly more tumours were removed subtotally (except of large tumours), massive hypothalamic dysfunction was eliminated, surgical deaths were reduced, and the chance for the improvement of the visual field increased. In the last years more patients with small tumours were treated, and less with medium-sized. Percent of patients with large tumours remains unchanged. The prospective study should be performed to define the proper planning of surgical treatment of large and giant tumours, including two-stages procedures.

Adenoma↗
PubMed1999

[Neuropsychological disorders after subarachnoid hemorrhage and surgery in anterior communicating artery brain aneurysms].

In the years 1982-1985 in the Dept. of Neurosurgery of the Jagiellonian University, 197 patients with anterior communicating artery aneurysms were operated on. Excluding multiple aneurysms (9), and taking into account early surgical losses (16), 172 patients were supposed to undergo late medical examinations. The patients were examined by means of questionnaires at least five years after surgery. 43 patients out of the 123 (71.5%) who handed in filled-in questionnaires, underwent psychological examination. Preliminary analysis of the late results of surgery indicates maintenance of the neurological disorders and symptoms. Within the group of examined patients (a neuropsychological examination, Wechsler Scale) it was found that 33 patients had considerable morbid decline in their mental condition and 4 patients moderate. 6 patients were not examined with Wechsler Scale because of aphasia (5 patients) and considerable deterioration of visual acquity (1 patient). The results of the neuropsychological examination showed that the symptoms that predominated were: short memory disorder, a slowdown in psychical and motor functions, conscious concentration disorder, elements of dynamic apraxia and increased tiredness as far as psychical process was concerned. 14 patients (32.6%) resumed work on their former posts, among them the 4 patients who had moderate morbid decline in their mental condition.

Adult↗
PubMed1998

[Current diagnostic methods in normotensive hydrocephalus].

Based on literature of the last 30 years we present the current view concerning diagnosis of the communicating hydrocephalus. Till now various methods of the assessment of hydrocephalus have been used in order to select patients for shunt treatment. No single factor, considered apart from the other diagnostic criteria, is sufficient to undertake the decision of shunting. According to current opinion the lumbar infusion test is the most valuable in the assessment of hydrocephalus, supporting us with the data of pressure-volume relations in patient. Based on our own experience the infusion test is not only useful in the preoperative investigation, but also for the assessment of proper shunt function.

Brain↗
PubMed1996

[Diagnosis and surgical treatment of acoustic neurinomas].

The authors present methods of diagnosis and results of surgical treatment of 210 acoustic neurinomas. Almost all patients suffered from large (21.4%) and very large (76.2%) tumours. Results of treatment were assessed depending on the method of surgery (classical and microsurgical), the size of tumour and the method of tumour removal (total or partial). Total tumour removal was achieved in 84.1% of patients operated on by means of microtechnique, and in 72.6% treated with classical method. Very good surgical results were observed in 52.4% and 38.3%, respectively. Difficulties and risk factors in surgery of large acoustic neurinomas were discussed.

Adolescent↗
PubMed1996

[Methods of surgical approach to cerebello-pontine angle tumors].

Based on literature and own experience the authors present operative approaches to the tumours of the cerebello-pontine angle. The technique of the suboccipital and supratentorial approach is discussed, its advantages an disadvantages and the risk of complications. Examples of surgical tactics depended on tumour size and the neurological state of the patient are presented.

Cerebellar Neoplasms↗
PubMed1996

[Soluble class HLA antigens in serum of patients with brain tumors].

The levels of soluble class I HLA antigens (s-HLA-I) in blood sera of patients with brain gliomas were studied before and after operation. It was found that sHLA material in sera was markedly decreased. The authors suggest the use of these examinations as one of the parameters of immune state of the oncologic patients before operation and in postoperative period.

Adult↗
PubMed1992

[Diagnosis and treatment of aneurysms of the lower segment of the vertebrobasilar system].

The authors present 20 patients with aneurysms of the vertebral artery and its branches, treated operatively. The symptomatology and the diagnostic methods in this group of rare vascular abnormalities are discussed. The authors are of the opinion, that there are no specific symptoms typical of this localization. All aneurysms of this group can be treated by suboccipital craniectomy. The results of the operation were good; in 75% the results were good or very good. 20% patients died.

Adult↗
PubMed1990

[Immediate and late results of surgical treatment of hydrocephalus after subarachnoid hemorrhage].

During the period from January 1st 1983 up to the end of April 1989 in the Neurology Department and the Neurosurgery Department 1417 patients were treated due to subarachnoidal hemorrhage. Among these patients in 275 cases the inner hydrocephalus was diagnosed using computer tomography (19.4%). In 17 cases (6.2%) hydrocephalus was treated surgically. In all patients the ventricle-atrial Pudenz valve was implanted; in 15 patients the valve was implanted for low pressure and in 2 for moderate pressure. The diagnostics was based on the computed tomography and angiography of cerebral vessels. In all cases large hydrocephalus was diagnosed (the anterior horn index in the computed tomography was below 3.0). The most frequent clinical symptoms were: urine incontinence (15 cases), disturbances of orientation (8 cases), akinetic mutism (8 cases) and paresis of extremities (7 cases). Above symptoms together with radiologic image presented indication for the valve implantation. Very good and good results were obtained in 13 patients, bad results in 2 cases, 2 patients died. Longer observation showed that 6 patients remain in satisfactory state, 3 patients are in bad state and 3 others died.

Adult↗
PubMed1980

[Ischemic complications of ruptured intracranial aneurysms].

Eighty patients are reported with ischaemic complications developing during subarachnoideal haemorrhage due to aneurysm rupture. Ischaemic complications developed in 12.82% of cases in the whole group of subarachnoideal haemorrhages caused by aneurysm rupture. The causes of ischaemia were: closure or stenosis of the afferent artery during the operation, arterial spasm, thrombosis at the site of the aneurysm and brain oedema. Ischaemia during intracranial aneurysm rupture caused in most cases pale infarcts. Ischaemic complications of aneurysm rupture had a serious prognosis, nearly half the patients with this complication died.

Adolescent↗
PubMed1977

[Case of double aneurysm located at the bifurcation of the basilar artery].

The authors report a case of two aneurysms at the bifurcation of the basilar artery in a 47-year old housewife. The technique for the exclusion of the aneurysms from the cerebral circulation using the operating microscope is described. The course of the illness and the patient's condition several months after procedure are described.

Basilar Artery↗