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Biomedical subjects

H E Clar

Publications and source records attributed to H E Clar.

At least 37 records · Page 2Linked to original sources
PubMed1979

Clinical and morphological studies of pituitary and diencephalic space-occupying lesions before and after operation, with special reference to temperature regulation.

In this study investigations are reported which analyze the clinical and morphological results in the treatment of diencephalic tumours. Depending on their location, these tumours are classified according to the extent of hypothalamic compression. The following parameters were studied: body temperature, blood pressure, pulse rate, serum electrolytes, water balance, and serum glucose. Hormonal tests were carried out to detect disturbances of pituitary and diencephalic function. The clinical findings were verified by morphological study of the hypothalamus in serial sections. The study covers 193 patients with sellar and diencephalic tumours. This analysis led to the following conclusions: 1. The postoperative temperature course is a reliable parameter for the diagnosis of diencephalic damage. 2. Diabetes insipidus is evidence of a diencephalic lesion. 3. Disturbances in the regulation of the serum glucose, electrolytes, blood pressure, and pulse rate are signs of a diffuse diencephalic lesion. 4. Endocrinological disturbances in the late phase indicate permanent diencephalic damage. This study indicates that the clinical findings in the acute postoperative period permit evaluation of the extent of the hypothalamic damage. These findings are consistent with Rothballer's observations on the pre-operative evaluation of these tumours.

Arrhythmias, Cardiac↗
PubMed1979

Comparison of encephalotomograms and computerized tomograms in midline tumours in infants.

Even after the introduction of the computerized tomogram, midline tumours in infants may give diagnostic problems. In the present study 41 children with tumours in the midline were investigated by both computerized tomography and encephalotomography. The results could be divided into two groups, according to the method and according to the localization of the space-occupying lesion. The diagnostic procedure may be restricted to computerized tomography in cases with direct signs (density differences, contrast enhancement). In cases showing indirect signs on the computerized tomogram (dislocation of ventricles or cisterns or both), further investigation would appear to be valuable. Encephalotomography is the method of choice in patients with negative or uncertain CT findings and contradictory clinical symptomatology.

Brain Neoplasms↗
PubMed1979

Classification of tumours in the sellar region using CT and encephalotomography.

Tumours in the sellar region may still present diagnostic problems. We therefore compared encephalotomographic and CT findings in sellar tumours and 91 patients were examined by both methods. For clinical purposes and operative treatment the degree of compression of the hypothalamus is of great importance. Encephalotomographic and CT findings are analysed and demonstrated. In cases of density differences between tumour and brain tissue shown by contrast enhancement, more information on the inner structure of a tumour (cystic or solid) can be obtained by computerized tomography. But if these are no density differences or/and contrast enhancement, tumour diagnosis is made easier by encephalotomography because of the great efficiency of this method.

Adenoma, Acidophil↗
PubMed1978

[Diagnosis of diencephalic disorders. Clinical study on the diagnosis of diencephalic disorders before and after surgery of tumors in the region of the sella and the diencephalon].

The clinical symptomatology of diencephalic disorders is studied in 193 patients operated because of tumors in the sellar region. A new classification of these tumors is established according to the localization and degree of compression of the hypothalamus. The following parameters were examined: body temperature, blood pressure, pulse rate, electrolytes, fluid balance, and serum glucose. In addition, hormonal tests for hypophyseal and diencephalic disorders were carried out. The analysis shows a significant postoperative temperature rise in patients with tumors in the hypothalamic region, depending on the degree of compression of the hypothalamus. There is no relation to histological findings or form of operative approach. Postoperative diabetes insipidus as well as endocrine diencephalic disorders correlate also with the degree of diencephalic lesion. The same results were found with glucose regulation. In contrast, blood pressure, pulse rate, and electrolytes show no differences in the groups tested.

Blood Glucose↗
PubMed1978

Limitations of computerized tomography in diagnosis of subdural hematoma.

CT findings in 51 patients with subdural hematomas are studied. Direct signs (hyperdensity, hypodensity) and indirect signs (any form of mass lesion) are distinguished. CT is limited with regard to determining correlations between time and the attenuation values. The factors which influence density of the hematoma are discussed. For a rational approach with subdural hematomas, which present diagnostic problems and reveal the limitations of CT diagnosis, a diagnostic scheme is proposed.

Cerebral Angiography↗
PubMed1978

Electroencephalographic investigations in sellar tumours, with special regard to different methods of operative treatment.

Sixty-six patients with tumours in the sellar region were examined. All were operated on either by the transfrontal or the transsphenoidal route. Pre- and postoperative longitudinal electroencephalographic investigations were performed. Preoperative electroencephalograms showed a normal frequency content in cases of intrasellar tumours or those reaching the chiasma. Nearly all cases had irregularities in the temporal regions. Tumours compressing the third ventricle had slower average frequencies and a general slowing in all cases. Besides these alterations unilateral delta waves or bitemporal dysrhythmic groups were sometimes found. A connection between extension of the tumour and its histological nature could not be found, but the operative approach influenced the electroencephalographic disturbances enormously. After a transfrontal approach and removal of the tumour the electroencephalogram was unchanged. Sometimes a mild transient bitemporal slowing was present. But after a transfrontal operative approach a general slowing was common, usually with focal marked slow activity in the right fronto-temporal area.

Adenoma, Acidophil↗
PubMed1978

[Encephalotomography and computer tomography for abnormalities of the sella (author's transl)].

Seventy-four patients with tumors in the sellar region were examined by means of encephalotomography and axial computerised tomography. In nearly all cases, the localisation and expansion of tumors could be exactly determined by encephalotomography. In addition, a graduation according to the degree of hypothalamic compression was possible. In cases of density differences between tumor and brain tissue and contrast enhancement more information of the inner structure of a tumor (cystic or solid) could be obtained by computerised tomography. But in cases of missing density differences or/and contrast enhancement tumor diagnosis is easier by encephalotomography because of the high efficiency of encephalotomography. The indication for the form of operative treatment, transsphenoidal or transcranial, depends on the exact knowledge of tumor growth, especially of the degree of hypothalamic compression. Therefore, in all uncertain computerised diagnosis encephalotomography has to be undertained.

Adenoma, Acidophil↗
PubMed1978

[Correlation of encephalotomography and computer tomography in space occupying lesions in the midline and cerebellopontine angle (author's transl)].

The diagnostic value of encephalotomography and computer tomography in neuroradiology of midline tumors is discussed. Characteristic differences of both methods are summarized. The following conclusions of clinical importance are derived from our experiences: 1. Computer tomography is the most valuable method in the diagnostic procedure of midline tumors. Encephalography is not necessary is cases with density differences of tumor and surrounding brain tissue or contrast enhancement. 2. Encephalotomography should be performed in cases with dislocation of cisternes and ventricles without density differences or contrast enhancement. 3. Encephalotomography is the method of choice in patients with unclear computer tomography and contradictory clincial symptomatology.

Adult↗
PubMed1977

[Spinal tumors].

Explore the source record for details and available documents.

Adolescent↗
PubMed1975

Demonstration of cervical spinal canal before and after fusion operation.

With the help of myelography using "oil soluble" positive contrast media, it is possible with a horizontal beam and a prone patient to outline the dorsal limit of the vertebrae and to estimate the degree of disc protrusion in the cervical region. In order to demonstrate the effect of anterior "ventral" fusion and especially the removal of the disc protrusion a large number of patients were again subjected to myelography following operation. It was; therefore, desirable that the contrast medium instilled pre-operatively should be mobilized in order to achieve such a demonstration in the cervical region. The method of operative myelography are described and illustrated by photographs.

Cervical Vertebrae↗