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Biomedical subjects

H Fodstad

Publications and source records attributed to H Fodstad.

At least 55 records · Page 3Linked to original sources
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↗
PubMed1987

Co-existence of abdominal aortic aneurysms and intracranial aneurysms.

The occurrence of abdominal aortic aneurysms (AAAs) and intracranial aneurysms (IAs) in the same patient and in the same family was studied among 89 patients with AAAs and 485 patients with IAs. Among the AAA-patients two had IAs themselves and five had IAs in the family, whereas three IA-patients had AAAs themselves and eight had AAAs in the family. Moreover, one of the patients with both AAA and IA had a blood relative with AAA, and in six of the families with both types of aneurysms there were more than two subjects with aneurysms. The results indicate, that AAAs and IAs may have a common aetiologic factor.

Adult↗
PubMed1987

Stereotactic localization of small subcortical brain tumors for open surgery.

A noninvasive, computed tomography (CT) stereoadapter was used for stereotactic localization of small brain tumors in 16 patients scheduled for open surgery. The stereotactic CT study was carried out 1 day to 3 months before surgery. On the day of surgery, the adapter was remounted on the patient's head. The tumor in relation to the adapter, as shown on the CT study, was drawn on the scalp of the patient. The tumor could be found and removed through a small bone opening and a minimal cortical incision.

Adolescent↗
PubMed1987

The Swedish experience in phrenic nerve stimulation.

Phrenic nerve stimulators (diaphragm pacers) were implanted in 20 patients with partial or total respiratory insufficiency of central nervous origin and chronic singultus. A 2-84 months follow-up (M = 41), 10 patients are entirely independent of a conventional respirator, two patients are partially dependent on respirator, three patients are dead, and five patients including two with hiccups had limited or no help from diaphragm pacing.

Electric Stimulation Therapy↗
PubMed1987

Genetic markers in patients with intracranial aneurysms.

HLA antigens, blood group systems (ABO, Rh, MNSs, P, Kell, Lewis and Duffy) and serum group systems (Hp, Tf, Gc, Pi, Bf, C3 and C4) were studied in a series of patients with intracranial aneurysms. A significantly increased frequency of HLA antigen A28, a significantly decreased frequency of HLA antigen B40, and a significantly decreased frequency of complement factor C4 B2 was found among the patients when compared with controls from the same geographic area.

Complement C4↗
PubMed1987

Intracranial aneurysms and heredity.

The occurrence of intracranial aneurysms (IAs) in the families of 579 consecutive patients with subarachnoid hemorrhage (SAH), of whom 485 had verified IAs, was studied retrospectively. IAs occurred in the families of 6.7% of the IA patients, but only 0.4% of their siblings had IAs. However, there were differences between the familial and nonfamilial IA patients, indicating that the familial patients are a specific small subpopulation of IA patients. The familial patients were younger, often had multiple aneurysms, and had aneurysms frequently located on arteries other than those in the nonfamilial group.

Adult↗
PubMed1987

When Nordic neurosurgery was still in its infancy.

Olof af Acrel, the father of Swedish Surgery, operated in 1768 upon a young nobleman who had experienced an increasing swelling on the skull, due to a tumour which also turned out to be growing deep into the brain parenchyma. The patient survived the operation for 3 days. Edvard Bull in 1877, after diagnosing a ruptured internal carotid artery aneurysm in a young female who temporarily recovered after her first hemorrhage, emphasised that the risk of a second, fatal haemorrhage--which in fact occurred--was immediate. He predicted that carotid ligation might be a way to reduce the risk of repeated haemorrhage from such aneurysms. Virtually unknown to modern neurosurgeons are many remarkable Nordic pioneers who, in the 1800's and early 1900's, rendered major contributions to the birth of modern neurological surgery. Thus early neurosurgical operations were performed by Carl Daniel von Haartman in Finland and by Christopher Withusen and Gundelach Møller in Denmark. von Haartman and Withusen had both visited Sir Astley Cooper in London in 1816. Vilhelm Magnus of Oslo was a neurosurgical giant, who had been trained by Victor Horsley during visits to London in 1903 and 1904. Magnus performed his first two-stage operation for a tumour located deep in the left cerebral hemisphere in 1903. By 1921, he had operated upon 112 cases of intracranial tumour with an 8.1% surgical mortality. His results were certainly fully comparable with those of his contemporary American pioneer--Harvey Cushing. Vilhelm Magnus, who worked alone under primitive conditions in small private hospitals, published altogether 70 scientific papers. In 1925 his series comprised 189 patients operated upon for brain tumours with 7.7% surgical mortality in supratentorial, and 17.8% mortality in infratentorial tumours. Magnus was congratulated on his brilliant achievements by a Swedish colleague 20 years his junior, Herbert Olivecrona, the man who was to carry on his pioneering work in Sweden.

History, 18th Century↗
PubMed1985

Phrenic nerve stimulation (diaphragm pacing) in respiratory paralysis.

Phrenic nerve stimulators (diaphragm pacers) were implanted in 16 patients with partial or total respiratory insufficiency due to high cervical medullary lesions and brain stem lesions (14 cases) or central hypoventilation syndrome (2 cases). At 5-72 months' follow-up (M = 35) 12 patients are entirely independent of conventional respirator, 2 of them after 8 years of total respirator dependency. Two patients are dead and the final 2 cases had limited help from diaphragm pacing.

Adolescent↗
PubMed1984

Effect of cranioplasty on cerebrospinal fluid hydrodynamics in patients with the syndrome of the trephined.

Forty patients with cranial bone defects after craniectomy underwent extensive cerebrospinal fluid (CSF) hydrodynamic investigations by means of a CSF infusion test before and after cranioplasty. The results of these investigations were related to the clinical signs of the patients before and after cranioplasty and to the size and location of the skull bone defect. Twenty-two patients were considered to have "the syndrome of the trephined" (ST). The remaining patients were either free of symptoms or had symptoms not related to ST. CSF hydrodynamic variables that were changed before and normalized after cranioplasty include the following: Resting pressure, sagittal sinus pressure, buffer volume, elastance at resting pressure and pulse variations at resting pressure. The changes were statistically significant mainly in ST patients who were also relieved of their symptoms after cranioplasty.

Adult↗
PubMed1984

Phrenic nerve stimulation (diaphragm pacing) in chronic singultus.

The authors implanted a diaphragm pacer in a 71-year-old man who had suffered for two years from continuous hiccup of unknown cause with resulting insomnia. Preoperative transcutaneous stimulation of the phrenic nerves in the neck resulted in diaphragm contractions but did not affect his hiccup. Postoperatively, the patient was free of symptoms for two weeks. Electrophrenic stimulation was then initiated and after three days his hiccup disappeared again. After a ten day period without stimulation his hiccup recurred. For ten months the patient has suffered from hiccup only in the day time during which time he has also used the pacer. With a few exceptions he has been free of symptoms and without pacing during the night, which enables him to sleep normally. The effect of phrenic nerve stimulation on hiccup could be due to interference with the abnormal activation of the phrenic nerve, whatever its cause.

Aged↗
PubMed1984

A battery-alarm system for phrenic nerve stimulators.

A simple alarm circuitry for unilateral diaphragm pacer transmitters has been constructed. The system, which is attached to the 9 V battery powered transmitter, will trigger an alarm sound when the battery voltage decreases to 8 V. The system may diminish or abolish the need for special supervision of patients with phrenic nerve stimulators.

Electric Stimulation↗
PubMed1983

Artificial respiration by phrenic nerve stimulation (diaphragm pacing) in patients with cervical cord and brain stem lesions.

In patients who are dependent upon respirators because of paralysis of respiratory muscles, pacemakers for electrical stimulation of the phrenic nerves, leading to contractions of the diaphragm, are available. We have implanted such diaphragm pacers in ten selected patients with partial or total respiratory insufficiency of central nervous origin. Preoperatively, transcutaneous phrenic nerve stimulation in the neck was undertaken with simultaneous fluoroscopy of the diaphragm and quantitative studies of ventilation and blood gases. Phrenic nerve stimulators were implanted bilaterally in eight and unilaterally in two patients. One patient died 3 weeks postoperatively from pneumonia, the remaining patients are entirely independent of respirator at a mean follow-up time of 20 months. Postoperative studies showed sufficient ventilation with diaphragm pacing in both sitting and recumbent body position. Their quality of life has improved. They still require permanent supervision and help with activities of daily life but all except one live in their homes. They can talk and some of them even attend school.

Adolescent↗
PubMed1982

Treatment of chronic obsessive compulsive states with stereotactic anterior capsulotomy or cingulotomy.

A neuropsychological model on how to evaluate patients subjected to stereotactic psychosurgery is presented. Four patients with chronic obsessive compulsive neurosis were randomly assigned to either stereotactic anterior capsulotomy or cingulotomy, and assessed pre-, peri-, and postoperatively according to this model. The best immediate and long-term follow-up results in reducing obsessional symptoms were obtained in the two capsulotomized patients. Psychosurgery should only be performed by a multidisciplinary team of specialists, with objective evaluation, adequate information on patients, and reliable test instruments.

Adult↗
PubMed1982

Antifibrinolytic treatment in subarachnoid haemorrhage: present state.

Two randomised controlled clinical trials in patients with recently ruptured intracranial aneurysms were undertaken using tranexamic acid (AMCA) to prevent early recurrent bleeding. In our accumulated series of 105 patients 53 were given AMCA and 52 were controls. 13% of the AMCA-treated patients and 31% of the controls rebled. In patients treated with AMCA the recurrent bleeding took place later than the rebleeding in the control patients. Vasospasm and delayed cerebral ischaemic deficits were seen more frequently in patients treated with AMCA. Total mortality from rebleeding and cerebral ischaemia was 25% in AMCA-treated patients and 19% in the controls during the six weeks' observation time. Coagulation factors remained unaffected by the drug. Local fibrinolysis in the cerebrospinal fluid decreased after one week in patients treated with AMCA. After two weeks the fibrinolytic activity was similar in AMCA-treated patients and in the controls. After experimental subarachnoid haemorrhage in 90 rabbits, AMCA was found to suppress plasminogen activator activity, mainly in the leptomeninges. This occurred however only during the first few postbleeding days. Antifibrinolytic agents only appear to reduce the risk of recurrent bleeding during the first ten day period after the primary aneurysm rupture. However they also seem to produce delayed cerebral ischaemia in patients with subarachnoid haemorrhage. Synthetic antifibrinolytics evidently shift the incidence of rebleeding curve to the right but these drugs are probably of diminished value in the subsequent weeks of risk.

4-Aminobenzoic Acid↗