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Biomedical subjects

F K Albert

Publications and source records attributed to F K Albert.

30 records · Page 2Linked to original sources
PubMed1995

Combined microneurosurgical and endovascular "trapping-evacuation" technique for clipping proximal paraclinoidal aneurysms.

A method is described in which a combined endovascular and microneurosurgical approach is used for clipping aneurysms of the proximal paraclinoidal segment of the internal carotid artery. By temporary occlusion of the cervical carotid artery and continuously retrograde sucking of blood from the distal vessel via a double lumen ballon catheter, clip application to large and critically located aneurysms is facilitated applying decompression to the trapped arterial segment under intraoperative somatosensory-evoked potential (SEP) monitoring.

Journal Article↗
PubMed1994

Amplification of the epidermal-growth-factor-receptor gene correlates with different growth behaviour in human glioblastoma.

The objective of our study was to determine the frequency of EGF-receptor-gene rearrangement in relation to tumour-growth behaviour in an unselected group of glioma patients. We investigated 73 glial tumours with different grades of malignancy (17 low-grade gliomas, 14 anaplastic variants, and 42 GBM) by Southern analysis, reverse transcriptase PCR (RT-PCR) amplification of mRNA, and Western analysis. An amplification of the EGF-receptor gene was present in 19/42 GBM but in only 1 anaplastic astrocytoma. By RT-PCR, 4/19 GBM with gene amplification showed a specific amino-terminal aberrant splice mutation of 801 bp in addition to undeleted mRNA. By Western analysis, 27/42 GBM showed expression of the EGF-receptor protein. Protein levels, however, varied among individual tumours. Four GBM containing an aberrant splice mutation exhibited an immunoreactive protein of 130 kDa MW in addition to the normal EGF-receptor protein p170. All GBM patients underwent surgery followed by a standard course of radiotherapy. Neuroradiological follow-up in 31/42 GBM patients consisted of bimonthly MRI examinations. There was a statistically significant difference in the mean latency period until tumour regrowth of patients suffering from GBM with and without EGF-receptor-gene amplification (9 weeks vs. 32 weeks). Our data indicate more rapid tumour regrowth kinetics of GBM with amplified EGF receptor genes in vivo.

Adolescent↗
PubMed1994

Early postoperative magnetic resonance imaging after resection of malignant glioma: objective evaluation of residual tumor and its influence on regrowth and prognosis.

In the vast majority of studies that address the role of surgery in the management of high-grade gliomas, the degree of tumor removal accomplished is solely based on the intraoperative perception of the neurosurgeon. Despite its fundamental importance for a comparison of different treatment modalities, little systematic effort has been made to evaluate the residual gross tumor by neuroimaging methods immediately after surgery. We report the results of a prospective study using contrast-enhanced computed tomography and magnetic resonance imaging (MRI) to monitor 60 patients after the resection of a high-grade glioma. In each case, the first scans were obtained between Days 1 and 5 after surgery, followed by serial imaging every 2 to 3 months, usually until the condition of the patient deteriorated severely or the patient died. Gadolinium-enhanced MRI proved to be extremely valuable for assessing gross residual tumor when performed during Days 1 to 3 after the resection of a preoperatively enhancing high-grade glioma. This timing avoided surgically induced contrast enhancement and minimized interpretative difficulties. In delineating residual tumor, MRI was vastly superior to computed tomography. About 80% of tumor "recurrences" emerged from definitely enhancing remnants, as revealed by early postoperative MRI. The neurosurgeon's estimation of gross tumor burden reduction could be shown to be much less accurate (by a factor of 3) than the postoperative assessment by modern neuroimaging. In our series, residual tumor enhancement was the most predictive prognostic factor of survival in patients with glioblastoma, followed by radiotherapy. Patients with a residual tumor postoperatively had a 6.595-times higher risk of death in comparison to patients without a residual tumor. Patients undergoing radiotherapy had a 0.258-times lower risk of death in comparison to patients who were not treated with radiation. Concerning survival, the prognostic significance of both variables surpassed age and performance.

Brain Neoplasms↗
PubMed1993

Clipping of proximal paraclinoid aneurysms with support of the balloon-catheter "trapping-evacuation" technique. Technical note.

A method is described in which we use a combined endovascular balloon-catheter technique and open microneurosurgical approach for clipping aneurysms of the proximal paraclinoidal intracranial segment of the internal carotid artery. By temporary occlusion of the cervical carotid artery and continuously retrograde sucking of blood from the distal vessel via a double-lumen balloon-catheter, clip application to large and critically located aneurysms is facilitated applying evacuation-decompression to the trapped arterial segment under intra-operative SEP-monitoring.

Adult↗
PubMed1989

Congenital brain tumours: diagnostic and therapeutic approach. With a report of 3 cases.

Three cases of congenital brain tumours are reported, which presented with signs of increased intracranial pressure soon after birth, giving rise to the suspicion of a cerebral haemorrhage or of hydrocephalus. Correct diagnosis of tumour was established by computerised tomography, which additionally demonstrated a concomitant haematoma in each case. Two of the newborns had a primarily fatal course, with no specific treatment of the tumours being feasible. The remaining child underwent two operations, experiencing an unhindered neurologic and mental development thereafter. The histologic diagnoses were spongioblastoma and medulloblastoma in the first two cases, and ganglioneuroblastoma in the last. A conspicuous clinicopathologic feature of this neuroblastoma was the marked change in its growth pattern, revealing a higher degree of histologic differentiation and less malignant biological behaviour when tumour regrowth occurred. The diagnostic, therapeutic, and prognostic implications for this special clinicopathologic condition are discussed, with a review of the relevant literature.

Astrocytoma↗
PubMed1989

[Subarachnoid hemorrhage and intracerebral hematoma in injury of the middle meningeal artery (aneurysma spurium)].

Traumatic lesions of meningeal arteries represent the typical cause of the acute epidural hematoma. Under certain circumstances, however, they may be the origin of space-occupying hemorrhages with only an intradural extent, e.g. subdural or intracerebral hematomas. We present a case of a temporal lobe hematoma with an additional subarachnoid hemorrhage. This gave rise to the suspicion of a spontaneously ruptured cerebral aneurysm that might have caused the patient's accident. Preceding the evacuation of the hematoma, cerebral angiography ruled out the suspected vascular malformation, but revealed a pseudoaneurysm of the middle meningeal artery close to a skull fracture. Intraoperatively, this lesion proved to be the source of the bleeding which was exclusively directed towards the intradural space. Presented is a review of the relevant literature regarding atypical hematomas secondary to meningeal artery lesions and traumatic aneurysms of these vessels.

Adult↗
PubMed1988

Lumbar intervertebral disk herniation with a concomitant nerve root neurinoma at the same site. Case report and review of the literature.

The coincidence of a lumbar disk herniation L4-5 and a neurinoma at the L5 nerve root in a 52-year-old male is reported. The clinical course revealed typical signs of a herniated disk, whereas the tumour was accidentally found by myelography initially performed for the suspected prolapse. Both lesions were removed without complications. The clinical and neuroradiologic aspects of this rare condition are discussed, with special regard to the problems of differential diagnosis. A review of the literature is added.

Humans↗
PubMed1986

[Tumor hemorrhage in intracranial tumors].

From 1975 to 1981, 50 patients with spontaneous hematomas due to intracranial tumours were treated in the Neurochirurgische Universitätsklinik Erlangen-Nürnberg. 33 tumours were located within the cerebral hemispheres, 6 within the oral brain stem, 6 tumours had a cerebellar origin, 2 neoplasms were located within the cerebellopontine angle, and 3 tumours grew in the sellar region. In most of the patients we found metastatic neoplasms (26%) and glioblastomas (22%), 6 tumours (12%) could not be identified histologically; 2 of these cases were assumed to be malignant gliomas. Two congenital tumours and a chondroma of the cerebellopontine angle were particularly notable. The incidence of tumour hemorrhage reported here was 4.1%. In 40 patients (80%) the hemorrhage was the cause of an acute clinical course, leading to death in 10 cases. 30% of the patients had to be operated on immediately, 32% were primarily treated in the intensive-care unit. Ten patients of the latter group died because of the acute hemorrhage. In the remaining 19 patients the course appeared to be less threatening and generally of an apoplectiform type. In about 50% the hemorrhage represented the first reliable sign of the hitherto asymptomatic tumour growth, in 32% it remained the only clinical diagnosis for a certain time. In 3 patients the brain tumours were not definitely diagnosed until some months later. One tumour was identified at autopsy. In pathological anatomy we could differentiate between several types of tumour bleedings. CT scan enabled the identification of the neoplastic origin in 86%, in 5 cases (10%) CT failed to yield the correct diagnosis. Twice CT scan had not been performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗
PubMedDate not supplied

Extirpation of glioblastomas: MR and CT follow-up of residual tumor and regrowth patterns.

PURPOSE: To optimize the timing of CT and MR after glioblastoma resection and to define the pattern of tumor regrowth. SUBJECTS AND METHODS: Sixty-eight patients with glioblastoma were studied prospectively with CT and MR. The first postoperative scan was obtained between day 1 and day 5; follow-up scans were obtained bimonthly. RESULTS: Residual tumor was shown most reliably on scans obtained shortly after surgery (MR, 77%; CT, 40.5%). After the fourth day up to 3 months postoperatively, surgically induced enhancement prevented recognition of residual tumor. Seventy-five percent of patients with residual tumor shown by early postoperative MR had progressive disease during follow-up, whereas only 36% of patients without evidence of residual tumor had MR signs of progressive disease. CONCLUSION: Early, enhanced, postoperative MR is the radiologic procedure of choice to determine the extent of glioblastoma resection. Gross total tumor resection as determined by early postoperative MR correlates with a prolongation of life.

Brain Neoplasms↗