Search PubMed⌕ Search

Biomedical subjects

F Umansky

Publications and source records attributed to F Umansky.

At least 37 records · Page 2Linked to original sources
PubMed1992

Fever as the initial sign of malfunction in non infected ventriculoperitoneal shunts.

Sixty eight children were treated for ventriculoperitoneal shunt malfunction in our department during the years 1984-1989. Fifteen (22%) developed fever above 37.5 degrees C as a presenting sign of their shunt malfunction. Physical examination did not reveal any reason for the fever. Cerebrospinal fluid, urine and blood cultures were all negative. All the children were operated upon and the malfunction corrected. Fever subsided twenty four to thirty six hours after the operation in all the patients. Fever of unknown origin in children with shunted hydrocephalus might be the first sign of a developing shunt malfunction and a neurosurgical examination should be requested.

Adolescent↗
PubMed1992

Surgical outcome in an elderly population with intracranial meningioma.

Thirty seven patients aged 70 and over (mean = 74 years) with an intracranial meningioma who had craniotomy between the years 1978-88 were reviewed. There were 20 women and 17 men. Resection was total in 28 (76%) and subtotal in 9 (24%) cases and each tumour was histologically verified. The location of the tumours were: base of skull 11, convexity 10, parasagittal 9, falx 6, and tentorial 1. The most frequent associated diseases were: hypertension (35%), chronic ischaemic heart disease (22%) chronic obstructive pulmonary disease (19%), and diabetes (14%). The Karnofsky Scale (KS) score before surgery ranged from 30 to 90 (mean = 59). It was less than 40 in ten patients. The length of anaesthesia during the surgical procedure varied from 4 to 12 hours and was not related to the outcome. There were two perioperative deaths (mortality = 5.4%). There were major complications in 8 patients and minor complications in 7 patients. In a mean follow up period of 29 months (shortest 6 and longest 96 months) the results were: excellent (KS 90-100) 39%, good (KS 70-80) 49%, fair (KS 60) 6%, and poor (KS 40-50) 6%. The difference between the mean preoperative KS value (KS = 59) and the mean postoperative KS value (KS = 80) was statistically significant (P less than 0.001). The results support a more aggressive therapeutic approach to the elderly patient with an intracranial meningioma.

Aged↗
PubMed1992

The microsurgical anatomy of the abducens nerve in its intracranial course.

The microsurgical anatomy of the abducens nerve through its intracranial course was studied in 20 specimens obtained from 10 cadaver heads fixed in formalin. Another 20 specimens were used to study the pattern of branching of the nerve trunk. The following intracranial segments were studied: subarachnoid or intracisternal, petroclival, and intracavernous. Angulations, neurovascular relationships, and branching patterns of the nerve are described. The long intracranial course of the abducens nerve, its tortuosity, and its tight attachment to the skull base at the level of the petrous apex may influence its vulnerability in some pathological conditions.

Abducens Nerve↗
PubMed1991

The use of fibrin sealant in cerebrospinal fluid leakage.

Cerebrospinal fluid leakage is one of the central problems facing neurosurgeons, both due to its occasional difficulty in management and to the catastrophical significance of ensuing infection. An important tool emerging in the surgical management of CSF leakage is fibrin sealant, the natural coagulation product. Thirteen cases of CSF leakage, due to meningomyelocele, posttraumatic, and secondary to tumor, that were managed surgically with fibrin sealant are presented. Several of the cases were successfully operated upon following failure of conventional surgical techniques. Additional uses of fibrin sealant in neurosurgery are discussed.

Adenoma↗
PubMed1991

Transverse ligament rupture and atlanto-axial subluxation in children.

We report four children aged two to nine years with traumatic tears of the transverse ligament of the atlas and atlanto-axial subluxation. This is extremely rare in this age group since trauma usually causes a skeletal rather than a ligamentous injury. The injuries resulted from falls or motor vehicle accidents, with considerable delay in diagnosis. Flexion radiographs showed atlas-dens intervals (ADI) of 6, 7, 8 and 13 mm; all four patients were treated by posterior fusion at C1-C2 after the failure of conservative treatment. In one child with quadriparesis and a fixed ADI of 13 mm, transoral anterior resection of the odontoid was performed before the fusion. Diagnosis of this traumatic lesion requires a high level of suspicion. Conservative treatment is likely to fail; surgical stabilisation is indicated.

Atlanto-Axial Joint↗
PubMed1991

Dorello's canal: a microanatomical study.

The microsurgical anatomy of Dorello's canal has been studied in 20 specimens obtained from 10 cadaver heads fixed in formalin. The bow-shaped canal through which courses the abducens nerve before reaching the cavernous sinus is located inside a venous confluence which occupies the space between the dural leaves of the petroclival area. The petrosphenoidal ligament (Gruber's ligament), which forms the posteromedial wall of the canal, appears as a fibrous trabecula surrounded by venous blood. Canal measurements were performed and its anatomical relationship with the sixth cranial nerve is described. Angulations of variable degrees were observed in the course of the nerve inside and outside the canal. The influence of this relatively tortuous course of the abducens nerve upon its vulnerability in some pathological conditions is discussed.

Abducens Nerve↗
PubMed1991

Hypertrophic spinal pachymeningitis: report of two cases and review of the literature.

The cases of two patients with idiopathic pachymeningitis hypertrophica that caused progressive paraparesis are presented. Gadolinium-enhanced magnetic resonance imaging was used to demonstrate this pathological entity in one patient, and myelography was used in the other. Decompressive surgery led to significant neurological improvement. The etiology, diagnosis, and management of this disease is discussed, and the literature is reviewed. To our knowledge, this is the first report to describe the features of this rare pathological entity on magnetic resonance imaging.

Aged↗
PubMed1990

[Surgery for craniopharyngioma].

We present a series of 20 patients (11 males) operated on for craniopharyngioma through a frontal craniotomy during an 11-year period. They ranged in age from 7 months to 58 years (mean 20 years). The most common symptoms were headaches, blurred vision and endocrine disorders. The perioperative mortality was 5% and morbidity 25%. 5 (25%) patients need reoperation; 13 (65%) received additional radiation therapy. In 94% visual function improved. 65% continued to have or developed endocrine problems, although all were well controlled with supplemental therapy. These results, similar to those reported from other centers, justify a combination of radical surgery and radiation therapy for this condition.

Adolescent↗
PubMed1989

Epidural haematoma and unilateral exophthalmos--a review.

Based on 9 cases in the literature and one of our own a review is made on the occurrence of an association of an intracranial epidural haematoma with unilateral exophthalmos. The possible pathogenesis of this infrequent phenomenon is discussed.

Brain Concussion↗
PubMed1988

Traumatic intratumoral hemorrhage secondary to a ventriculoperitoneal shunt.

We report a case of a 14-month-old boy with a primary intraventricular oligodendroglioma and obstructive hydrocephalus. The child underwent a bilateral ventriculoperitoneal shunt and developed a massive and fatal intratumoral hemorrhage initiated by a mild trauma when introducing the left ventricular catheter. To our knowledge, this is the first report in the literature of such a complication during a shunting procedure for obstructive hydrocephalus of tumoral origin.

Cerebral Hemorrhage↗
PubMed1988

Cystic changes in intracranial meningiomas. A review.

A survey on cystic meningiomas is given based upon the analysis of 85 cases in the literature and an additional three of our own. In these three cases the computerized tomography appearance led to an incorrect preoperative diagnosis of necrotic glioma or metastatic lesion. The tumours were totally removed and the definitive diagnosis of meningioma was histologically confirmed. In reviewing the literature, we found 85 cases of intracranial meningiomas with cystic changes reported. Their pathological and radiological findings are discussed.

Aged↗
PubMed1988

Technical note: the removal of free peritoneal catheters in the revision of ventriculoperitoneal shunts.

The widespread usage of ventriculoperitoneal shunts has been followed by a plethora of complications. One of these complications, the separation and migration of the distal tubing to be free intraperitoneally, has been relatively disregarded in the literature both as a phenomenon and as to treatment. We present our experience with nine such cases, four involving two peritoneal catheters. Unless contraindicated, we think that such tubing should be removed during shunt revision by single digit blind palpation of the tubing. No complications arose from this procedure, and the postoperative course was uneventful. The indications for this procedure are discussed in relation to the relevant literature.

Cerebrospinal Fluid Shunts↗
PubMed1988

Anomalies and variations of the middle cerebral artery: a microanatomical study.

The microvascular anatomy of the main trunk and divisions of the middle cerebral artery was studied in 104 unfixed brain hemispheres injected with polyester resin and dissected under the operating microscope. The following anomalies and variations of the middle cerebral artery were found: fenestration (1 case; 1%), located on the first 4 mm of the main trunk of the middle cerebral artery; duplication (1 case; 1%), with vessels arising from the internal carotid artery; accessory middle cerebral artery (2 cases; 2%), originating on the A1 segment of the anterior cerebral artery; single-trunk type of middle cerebral artery (4 cases; 4%), with no division of its main trunk; quadrifurcation (4 cases; 4%), in which the main trunk of the middle cerebral artery divided into four secondary trunks. The clinical implications of these anatomical findings are discussed, and photographs of representative specimens illustrate the anomalies.

Cerebral Arteries↗