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Biomedical subjects

C von Essen

Publications and source records attributed to C von Essen.

At least 37 records · Page 2Linked to original sources
PubMed1988

Stabilization of the unstable upper cervical spine in rheumatoid arthritis.

We present our clinical experience and the results of surgical treatment of 13 patients with rheumatoid involvement of the cervical spine, namely severe atlanto-axial dislocation. A posterior fusion was carried out using a bicortical H-shaped iliac crest bone graft and steel wire. Postoperatively all patients were immobilized for 8 weeks in a Halo cast. There were no postoperative complications and all patients showed a stable fusion confirmed by radiography. Complete pain relief was obtained in 9 patients, partial in 4.

Adult↗
PubMed1988

Aneurysmal subarachnoid haemorrhage: overall outcome and incidence of early recurrent haemorrhage despite a policy of acute stage operation.

A series of 480 patients who were alive upon admission following an aneurysmal subarachnoid haemorrhage (SAH) is reported. These patients represented 40% of the total Swedish incidence during a 3-year period. The three neurosurgical referral centres covering this population had a similar policy of early diagnosis and acute state surgery in all patients considered of having a potential to survive without permanent disabling cerebral malfunction. At 2-year follow up 45% showed a good neurological recovery, the morbidity was 25% and the mortality was 30%. Some more lives might have been saved with an improved ultra-early referral system since there were 21 initially good-to-fair risk patients (4% of the total SAH population) who rebled fatally before surgery and within 48 h. For comparison, in the Kingdom of Denmark, with a general policy of delayed operation, out of 1076 patients who were alive upon admission, 27.5% made a good recovery, while the morbidity was 27%, and the mortality was 45.5%.

Humans↗
PubMed1988

Significance of "ultra-early" rebleeding in subarachnoid hemorrhage.

Knowledge of the local incidence of aneurysm rupture permits the conclusion that almost every patient in the population of 933,800 persons served by the authors' institution who was stricken by this catastrophe and survived long enough to be transported was treated at this center (121 patients during 34 months). Of these, 9.1% were admitted late (greater than 72 hours after subarachnoid hemorrhage (SAH]; of the remaining cases, 94.5% were seen within 24 hours and 50% within 6 hours post-SAH. Of the 121 patients, 10% were neurologically devastated on arrival, a late operation was planned for 19%, and the earliest possible surgery and nimodipine administration was selected for 71%. In this latter group, 50% of the operations were begun within 24 hours and 76% within 48 hours post-SAH. Sixty percent of all mortality and morbidity could be linked to the initial aneurysm bleed. The remaining 40% could be ascribed to potentially avoidable causes of unfavorable outcome. No less than 9.6% of all patients admitted within 24 hours after SAH suffered from "ultra-early" rebleeding during transportation or preparation for operation. The mortality rate from such rebleeding was 7.4%, compared with the 9.1% combined mortality rate from complications and late ischemia.

Female↗
PubMed1988

[Psychotherapy institutions and their patients].

This article investigates a number of institutions and private practices involved in the Berlin psychotherapy study from the point of view of their patients and their offerings in the area of therapy. Certain similarities have been found to exist between the institutions in the sex and age structure of the patients as well as in terms of the high level of previous experience with psychotherapy and psychoanalysis and previous medical measures. None of the institutions or practices saw primarily socially privileged patients, as is sometimes maintained. To a considerable degree the people they see live in a destabilized situation or one that is not yet stabilized and enjoy little social certainty (ca. 50%). The rate of the indication for psychotherapy and its actual initiation varies considerably from one institution to another. It runs the spectrum from the municipal counseling services, whose little motivated patients are only open to psychotherapy at all at a rate of 50% (actual therapy 22%) to patients in private psychotherapeutic practices who have gone through a long motivational process and who begin therapy at a rate of 70%. Study of the relationship between the location of the institution and the area in which the patients live shows on the one hand a tendency toward regionalism insofar as institutions are preferred by the patients who live near by. On the other hand, these special institutions are also sought out by patients from more distant locations and from differently structured areas; these patients are represented to the same degree as patients from the immediate area. Although psychotherapeutic institutions are often situated in the "better" residential areas, their patients are by no means only from such privileged areas but from all regions, including those that are socially weak.

Adult↗
PubMed1987

Indirect injury to cranial nerves after surgery with Cavitron ultrasonic surgical aspirator (CUSA). Case report.

The Cavitron ultrasonic surgical aspirator (CUSA) was used in a patient with an acoustic nerve tumour. After surgery she presented unilateral palsies of several cranial nerves. The nerve injuries were most likely induced by ultrasonic energy transmitted from the CUSA via the petrous bone. We suggest that when the CUSA is used in such operations care should be taken to avoid contact between the vibrating probe of the CUSA and the petrous bone.

Aged↗
PubMed1984

Traumatic aneurysms of cerebral arteries. A study of five cases.

Five cases of traumatic aneurysms of cerebral arteries are presented, two located at the internal carotid artery, and three at peripheral arterial branches. The manifestation of the aneurysm was a delayed neurological deterioration due to bleeding from the aneurysm, 4-35 days (mean 21 days) after the head trauma; four patients had an intracerebral haematoma and one patient had a subarachnoid haemorrhage. One patient died from extensive cerebral injuries with the aneurysm untreated. In four cases the aneurysm was treated surgically. Three patients returned to their former occupation and one patient died from late septic complications. It is concluded that signs of delayed intracranial bleeding after a head trauma should raise the suspicion of an underlying traumatic aneurysm, and in addition to a CT-scan an angiography should be performed.

Adult↗
PubMed1981

A large convexity meningioma followed by liquorrhoea from a nasal encephalocele. A case report.

A 46-year-old woman was readmitted, two years after removal of a large convexity meningioma, because of cerebrospinal fluid rhinorrhoea from a nasal encephalocele eventually visualized by CT-scan. The encephalocele was extirpated via an intracranial approach, and its histological appearance is described. The aetiology of this extracranial brain tissue protrusion is discussed. It is suggested that the mechanisms behind the formation of this encephalocele are a combination of a congenital malformation and the long term increase of the intracranial pressure due to the meningioma.

Brain Neoplasms↗
PubMed1980

VOI thalamotomy in spasmodic torticollis.

We performed stereotactic VOI thalamotomy as the only surgical treatment in spasmodic torticollis in 17 patients since 1972. The patients selected for surgery mainly presented horizontal torticollis. All the patients improved after unilateral thalamotomy. In most cases there was a delay in improvement varying from 3 months to 2-3 years postoperatively. The severity of the psychic disturbances present in most patients at the time of onset of their torticollis did not have any relevance to their final outcome after surgery.

Adult↗
PubMed1980

Local cerebral blood flow in the dog during intravenous infusion of dopamine.

Local cerebral blood flow was measured in anaesthetized beagle dogs by the hydrogen clearance method. Dopamine was administered as a continuous intravenous infusion of varying doses. The changes in local cerebral blood flow induced by dopamine were similar at the different locations; i.e., the caudate nucleus, thalamus, frontal and parietal cortex. Blood flow responded to dopamine in the following ways: low dose (less than 2 micrograms/kg/min): blood flow decreased or remained unchanged; moderate doses (2--6 micrograms/kg/min): blood flow increased at all electrodes; high doses (7--20 micrograms/kg/min): blood flow decreased once again. The decrease in blood flow could be inhibited by the alpha-adrenergic receptor antagonist phentolamine or by the serotonin receptor antagonist methysergide. This indicates that the constrictor effect of dopamine on cerebral blood vessels is mediated via alpha-adrenergic receptors as well as via serotonin receptors. The increase in cerebral flow could be inhibited by the dopamine receptor antagonist haloperidol, indicating vascular dopamine receptors in the brain with a dilating effect. When the vasoconstrictor activity of dopamine is blocked, the single response to a dopamine infusion is a blood flow increase. This might be beneficial in the clinical situation of symptomatic vasospasm.

Adenosine↗
PubMed1979

Cerebral blood flow, cerebrovascular resistance and cerebral metabolic rate of oxygen in severe arterial hypoxia in dogs.

Cerebral blood flow and cerebral oxygen uptake were studied during severe arterial hypoxia in anesthetized dogs. It was shown that the hypoxic vasodilatation in the brain reaches a limit at an arterial oxygen saturation at about 25% and that this vasodilatation is less than that which may be induced by hypercapnia. A further deepening of the arterial hypoxia at a maintained cerebral perfusion pressure is combined with a continuous decrease in cerebral venous oxygen tension and a reduced oxygen uptake.

Animals↗
PubMed1979

Cerebral blood flow, cerebrovascular resistance, cerebral metabolic rate of oxygen and intracranial pressure during and after severe prolonged arterial hypoxia in dogs. The role of dopamine in the deep hypoxic state.

The effect of extreme, prolonged arterial hypoxia on cerebral blood flow, oxygen uptake and intracranial pressure was studied in anesthetized dogs. The experiments were performed along two lines. Both started with a period of hypoxia of about 40 minutes to 2 hours. Thereafter normoxia was restituted in one group and the animals were studied for another 1-2 hours. In the other group with continued hypoxia dopamine was administered. During the hypoxic period the cerebral blood flow decreased mainly as a result of vasoconstriction after an initial marked flow increase. Cerebral oxygen uptake was reduced. Intracranial pressure increased, largely in proportion to blood flow changes, and no indication of important brain edema appeared. In the "recovery" period at normoxia the cerebral oxygen uptake showed an increase during the observation time. The blood flow, initially high, returned to the control level within the observation period. Dopamine infusion during continued hypoxia induced a vasodilatation, with reduction of vascular resistance to the values found at the induction of hypoxia, and with an increase of the cerebral oxygen uptake. An important role of endogenous dopamine in the hypoxic vasodilatation is suggested.

Animals↗
PubMed1978

Studies on the influence of monoamines on the cerebrovascular response to arterial hypoxia.

The cerebrovascular response to arterial hypoxia was studied during blockade of the vascular dopamine receptors and during alpha-adrenergic receptor stimulation and blockade in anaesthetized dogs. Dopamine receptor blockade with pimozide or haloperidol invariably decreased the degree of hypoxic vasodilatation in the brain pointing to a functional role of dopamine in this situation. Alpha-receptor blockade did not change the response, while stimulation of these receptors decreased the dilatory response even in deep arterial hypoxia.

Animals↗
PubMed1977

Spinal teratoma.

A very rare case of intramedullary spinal teratoma without spina bifida is described in a man with congenital kyphoscoliosis. A connection is suggested between the spinal tumour and the dorsal deformity.

Adult↗