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Biomedical subjects

H A Walder

Publications and source records attributed to H A Walder.

At least 19 recordsLinked to original sources
PubMed1989

The tethered spinal cord syndrome: a correlation of radiological features and peroperative findings in 30 patients.

The aim of this investigation is to evaluate the accuracy of the diagnostic parameters of the radiological features, especially in conventional lumbar myelography, since these will be used in the future as a gold standard for new developing diagnostic methods like ultrasonography (US) and magnetic resonance imaging (MRI). A short review of the clinical symptoms and diagnostic radiology of the tethered spinal cord (TSC) is given. The radiological features of the TSC syndrome are compared with the peroperative findings in 30 patients investigated and operated in our hospital. All patients showed lumbar or sacral osseous malformations on the plain X-ray films. This means a high diagnostic sensitivity although the specificity for TSC is low. Conventional myelography had a sensitivity of 0.82 and positive predictive value of 0.94, while the specificity and negative predictive value are respectively 0.96 and 0.85. The positive predictive value of the total diagnostic procedure of plain X-ray films and lumbar myelography for TSC may be estimated at 1.

Humans↗
PubMed1984

The tethered spinal cord syndrome.

The results of surgical treatment of the tethered spinal cord syndrome in twenty-five children in the age range six weeks to nineteen years are reported. After a description of the symptomatology, the importance of neuroradiologic investigations including myelography and CT-scanning as well as urodynamic studies are explained. The operative techniques are described in cases of tight filum terminale, lipoma of the filum terminale, diastematomyelia, lipomyelomeningocele and meningocele. Early operation is essential to avoid the neurological damage which results from awaiting the onset of symptoms. The aim of the operation is to free the conus medullaris and cauda equina before mechanical traction or compression damages function in lumbosacral cord.

Adolescent↗
PubMed1981

The preselection value of the Doppler LP test for shunt-therapy in patients with normal pressure hydrocephalus.

The results of this study confirm the hypothesis that the simple innocuous Doppler LP test may be useful in obtaining information about CSFP-CBF (cerebrospinal fluid pressure-cerebral blood flow) relationships. The value of this test in predicting the clinical outcome of CSF shunting in patients with normal pressure hydrocephalus (NPH) was studied. Fourteen patients with NPH were examined; eight patients showed a positive and six patients a negative Doppler LP test. Seven of the eight patients with a positive test improved following the shunting procedure, but none of the six patients improved after operation. This study suggests that the Doppler LP test is a useful preoperative selection test in patients with NPH. In addition this study supports the hypothesis that CBF autoregulation may be impaired with NPH.

Adolescent↗
PubMed1980

Diagnostic accuracy of lumbar myelography in the detection of lumbar disk herniations.

Recent literature shows the high degree of diagnostic accuracy of lumbar epidural phlebography in the diagnosis of disk herniation; lumbar myelography seems to be of less value. In our study we could prove that the diagnostic accuracy of both methods can be of equal level if the technical performance of lumbar myelography meets high demands of quality.

Humans↗
PubMed1980

[The spontaneous cerebral hematoma (author's transl)].

This retrospective study from two hospitals is about a hundred patients who have been operated upon a spontaneous cerebral hematoma. By a spontaneous cerebral hematoma we mean a hematoma without a proven tumor, without aneurysm, without arteriovenous malformation, without preceding trauma, without aortical phlebitis and without pathology of the vessel-wall. In this study patients with coagulopathy, arterial hypertension and artherosclerosis are included. In order to comply with these conditions an angiography will have to take place pre-operatively as well as postoperatively. Moreover histological examination of the wall of the hematoma will have to be done. The etiology of the spontaneous cerebral hematoma is not clear in most cases. The indication to operate, the way of operating and the moment in which the operation takes place, vary strongly in medical literature. We operate when there is an aggravation of the clinical picture, persisting severe headache and neurological paresis which does not improve. As a rule we abide for one week before operating, if the clinical picture allows this. After the operation unconscious patients may recover and a hemiparesis may improve. The best way of diagnosing a cerebral hematoma is computerised tomography.

Adult↗
PubMed1976

Acquired basal encephalocele.

The radiodiagnostic signs of congenital basal encephalocele are well known. The case history described here shows that a long existing, acquired, traumatic transethmoidal encephalocele can cause the same roentgen appearance. The differences between the congenital and recent posttraumatic forms are indicated.

Adolescent↗