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Biomedical subjects

C B Lumenta

Publications and source records attributed to C B Lumenta.

52 records · Page 3Linked to original sources
PubMed1991

[MRT in syringomyelia--follow-up control after syringo-arachnoid shunt surgery with clinical correlation].

In 8 patients with syringomyelia, MR long-term follow-ups (observation period 25-46 months) were done after syringosubarachnoidal shunt operations. MR showed directly after surgery in 6 cases an extensive collapse of the syringomyelias and in 2 cases a lesser reduction of the diameter of the syrinx. During the subsequent course the size of the cavities increased again in 3 cases. The size of the syrinx visualised by MR did not correlate with the clinical status during the follow-up studies. This seems to point to an insufficient representation of the disease process by the morphological visualisation of the size of the syrinx.

Adult↗
PubMed1991

[Intraoperative monitoring with evoked potentials in spinal interventions].

This review article delineates the physiology and methodological principles of somatosensory (SEP) and motor evoked potentials (MEP), as well as our own results in 40 patients monitored during spinal surgery. In 29 patients an intraoperative SEP and in 15 patients a MEP monitoring was performed. Both modalities were applied in 4 patients. 19 patients had an intramedullary tumor, 15 patients had an intradural extramedullary tumor, 4 patients had an extradural mass lesion, and 2 patients had a spinal arteriovenous malformation. Technical problems with SEP monitoring occurred in 3 of 29 cases, problems with MEP monitoring occurred in 4 of 15 cases. Whereas anesthesia showed only little influence on SEP, an appropriate anesthesiological management was of major importance for MEP monitoring. Other factors, e.g. body temperature and blood pressure, also affected the evoked potentials. In all 35 patients in whom intraoperative SEP and/or MEP monitoring was successfully performed, evoked potentials showed a clear correlation with the initial postoperative neurological findings i.e. there were only cases of correct positive or correct negative monitoring. Transient evoked potential changes could always be attributed to surgical maneuvers. Our results show that intraoperative spinal cord monitoring with both SEP and MEP can supply helpful information on neural integrity. The choice of the evoked potential modality to be used and the choice of the sites of stimulation and recording depends on individual pathoanatomical findings and on the operative procedure required. Intraoperative evoked potential monitoring is indispensable during high risk spinal surgery such as surgery for intramedullary tumor or for mass lesions above C5.

Afferent Pathways↗
PubMed1990

Clinical experience with a pressure-adjustable valve SOPHY in the management of hydrocephalus.

Seventy-four patients with hydrocephalus due to a variety of causes were treated with a cerebrospinal fluid (CSF) shunt, incorporating a recently developed pressure-adjustable valve SOPHY (PAVS). The PAVS may be changed percutaneously with the help of an externally applied magnet in order to select a high-, medium- or low-valve opening pressure, whenever the need for a change in pressure characteristics seems necessary to the neurosurgeon. The percutaneous pressure adjustment obviated up- or downgrading of a medium pressure position by surgical means in half of our patients during the follow-up time (up to 39 months; mean follow-up 16.7 months). In 66 patients (89%) decreased ventricle volume and improvement of the clinical sign of increased intracranial pressure were established. In 11 patients a valve or a catheter infection occurred; in 6 of these patients the valve had to be removed. Half of this group consisted of patients under 2 years of age. Significant technical complications related to the PAVS did not occur in our series but until a somewhat smaller PAVS is available, we cannot recommend its use in neonates or in small infants. In all other patients the PAVS is a very valuable instrument in the surgical management of hydrocephalus because it makes shunt revisions for inadequate valve pressure obsolete in individual patients.

Adolescent↗
PubMed1989

Brain stem auditory evoked potentials (BAEP) monitoring in brain death.

In our intensive care unit, brain stem auditory evoked potentials (BAEP) are measured continuously in comatose patients. For this study we examined 15 patients who fulfilled the criteria of brain death (2). Loss of BAEP in these patients inevitably means loss of brain stem function and consecutive death. Our investigation shows that continuous BAEP monitoring can be helpful for the assessment of brain death and for the earlier decision of organ explantation.

Aged↗
PubMed1989

Endotheliomatous meningioma with coalescing microcysts, presenting as an hypodense lesion with ring enhancement on computed tomography.

Computed tomography (CT) revealed a hypodense intracranial tumour that showed a slight ring enhancement and a peripheral tumour nodule. Although this suggested a cystic astrocytoma, angiography identified a meningeal tumour. Microscopical examination demonstrated a cystic endotheliomatous meningioma. Neuropathological and intraoperative findings suggested that the meningioma was an intermediate form between the microcystic and macrocystic types, illustrating the evaluation from the former to the latter.

Cysts↗
PubMed1988

Magnetic resonance (MR) imaging in the management of primary and secondary syringomyelic cavities, and of other cystic lesions of the spinal cord.

During the past three years 27 patients with medullary and/or brainstem cavities were examined with MRI at the Institute of Roentgenology, and we report the radiological MRI correlative findings. Five patients were operated: postoperative MRI examinations were compared with preoperative studies. Syringomyelia was present in 21 cases, syringobulbia in 2, and syringobulbomyelia in 4. Additional pathology such as the Arnold Chiari malformation or hydrocephalus was found at the craniospinal junction in 8 patients. Two instances of associated intraspinal tumours were noted too. In all cases the syringomyelic cavities involved the cervical cord and in most of them the lesion extended down to the thoracic or even lumbar level. Several patients were shown to have multilocular cavities. In the patients with syringomyelia a syringoarachnoidal shunting procedure was performed. This resulted in cyst collapse as proved by postoperative MRI examinations; neurological symptomatology was ameliorated too. Conventional radiological imaging with computed tomography (CT) and myelography was not as efficient as MRI in imaging syringomyelia. The extent of intramedullary cavities as well as the presence of associated pathology is best appreciated on sagittal MRI. The use of special surface coils clearly results in better image quality due to higher resolution. According to our experience MRI should be the primary examination in syringomyelia; myelography and CT are obsolete in the management of syringomyelia; the insertion of a syringoarachnoidal shunt is a convenient surgical procedure, resulting in clinical amelioration in most cases.

Adolescent↗
PubMed1985

Measurements of brain-stem auditory evoked potentials in infancy, childhood, and adolescence.

Brain-stem auditory evoked potentials (BAEPs) were measured in 38 patients between 3 months and 18 years of age. In patients with blunt head injuries (N = 28; 73.7%) no significant correlation between BAEP changes and final outcome could be established until day 36 with the exception of wave III changes in 3 children. Because various BAEP abnormalities occurred in all outcome groups and the nature of the changes was transient, we conclude that within this age group there must be a higher resistance to various lesions until irreversible impairment of brain-stem function results. In spite of this result, continuous BAEP recording in this age group appears useful, since this noninvasive investigation represents an objective assessment of topical brain-stem function.

Adolescent↗
PubMed1985

Protein and amino acid metabolism after severe cerebral trauma.

Fourteen patients (20-48 years) suffering from severe head injury were followed for changes in amino acid and protein metabolism during the first 8 days after trauma. All patients received a standardized intravenous nutrition containing 15.7 g of nitrogen per day and additional carbohydrates. Electrolytes, free water, and blood constituents were given as needed. Additional treatment included surgical decompression of space-occupying hematomas, high dose dexamethasone therapy, and controlled hyperventilation for at least 5 days. Gross changes of protein metabolism were observed particularly on the days 5 and 6. The duration and chronological sequence of these changes are different from those usually found in patients with multiple injuries.

Adult↗
PubMed1985

[Monitoring of auditory function in comatose patients in therapy with potentially ototoxic substances using acoustically evoked brain stem potentials].

Brain-stem auditory evoked potentials were measured in 14 comatose patients treated with aminoglycosides in cases of bronchopulmonary infection. Patients treated with tobramycin showed little influences on the latencies of wave 1, whereas treatment with amikacin resulted in enhanced wave 1 latencies even after completion of therapy. These changes were observed with therapeutic plasma levels of the aminoglycosides in all cases. As a method of bedside monitoring of auditory function with no additional stress to the patient with immediate results monitoring brain-stem auditory evoked potentials is recommended as a routine method to control auditory function in comatose patients under administration of aminoglycosides.

Adult↗
PubMed1984

Measurements of brain-stem auditory evoked potentials in patients with spontaneous intracerebral hemorrhage.

Brain-stem auditory evoked potentials (BAEP's) were recorded in 19 patients with spontaneous intracerebral hemorrhage. More than half of the patients were deeply comatose. There was no correlation between BAEP changes and different types of spontaneous intracerebral hemorrhage or between BAEP's and coma grading by the Glasgow Coma Scale. However, BAEP's were a significant prognostic aid in these cases and useful in indicating the level of the brain-stem lesion.

Adult↗
PubMedDate not supplied

Xanthogranuloma of the Erdheim-Chester type within the sellar region: case report.

Manifestations of Erdheim-Chester disease in the central nervous system are very rare. Cases with localization in the retroorbital space, hypothalamic area and posterior pituitary as well as intracerebral lesions are known. In our neurosurgical unit, a 51-year-old male patient with a history of hypophyseal insufficiency and visual deficits underwent surgery for a pituitary lesion. Histological and immunohistochemical examination revealed a xanthogranulomatous lesion composed of very large CD68-positive foam cells with small nuclei and some Touton-like giant cells, histiocytes, as well as loci with small lymphocytes and isolated eosinophilic granuolcytes, embedded in fibrotic tissue. Based on these findings, the histological diagnosis was a xanthogranuloma of the Erdheim-Chester type.

Granuloma↗