Investigations into possible roentgenographic errors in stereotaxis.
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Brain Mapping↗
Biomedical subjects
H Uhl
Publications and source records attributed to H Uhl.
[Diagnostic difficulties in a polytrauma case].
Even with the advent of the present diagnostic possibilities, polytraumas are still a serious problem with a large mortality. Owing to the complexity of the clinical picture, severe craniocerebral injury masks other extracerebral signs and creates a risk of unnoticeable injury of another organ. We describe a case of a 63 year-old patient, who suffered a polytrauma in road accident. A typical treatment of traumatic subarachnoid haemorrhage was administered and patient's state of consciousness improved. On 5-th day after the trauma the patient's state deteriorated. The neurological examination didn't reveal intracranial hypertension signs. Increasing anaemia was detected and an extracerebral reason of deterioration was sought. The following x-ray picture of chest was taken revealing elevation of the diaphragm without any other posttraumatic lesions. The patient was selected for thoracosurgical operation because pericordial sac disruption and diaphragm contusion were found. The pericardial sac was sutured. During further treatment the patient's state improved. He was discharged walking and independent.
Diagnosis, Differential↗
[Piracetam in severe cranio-cerebral injuries].
A group of 100 patients treated immediately following a cranio-cerebral injury was analyzed. The patients, administered piracetam either in an intravenous infusion (GCS 3-8) or orally (GCS above 9), were divided into groups depending on the dose and clinical status. Piracetam participates in the activity of the majority of neurotransmitters, increases glucose and oxygen consumption in the ischaemic nervous tissue and increases blood flow through cerebral terminal vessels. In cranio-cerebral injuries, piracetam is employed to achieve cytoprotection and improve cerebral blood flow. In patients with neurological deterioration following the administration of 6-10 mg/day, no good results were obtained. A dose of 24-30 mg/day had a significant positive effect on therapeutic results providing certain conditions were met, such as ensuring proper partial oxygen pressure (oxygen therapy) and proper blood glucose levels. The use of piracetam is justified immediately after an injury; after the discharge oral piracetam therapy is recommended.
Brain Injuries↗
[Prognostic significance of early CT changes in ischemic stroke patients].
The aim of the study was to establish the prognostic value of early CT findings in predicting the 30-day mortality after stroke, to assess the prevalence of these findings in acute stroke patients, and to examine the correlation between these findings and the clinical status. 134 patients (mean age 67.5 +/- 12.1) with supratentorial ischaemic stroke and CT performed within 12 hours from onset of the symptoms were included into the study. The neurological deficit and consciousness disturbances were assessed by means of Scandinavian Stroke Scale. The 30-day mortality was registered. CT findings were found in 84 (63.7%) patients, including hypodense lesions in 74 (55.5%), mass effect in 55 (41.0%) and hyperdense middle cerebral artery sign in 5 (3.7%) cases. Patients with mass effect had greater neurological deficit on admission (p < 0.0001), more frequently developed disorders consciousness (p = 0.001) and had greater 30-day mortality (p < 0.0001). Patients with hypodense lesions of at least two types presented with greater neurological deficit observed on the second day of hospitalization (p < 0.05) and had also greater 30-day mortality (p = 0.01). On multivariate analysis mass effect seen in early CT, as well as older age and greater neurological deficit appeared to be independent predictors of 30-day mortality.
Aged↗
[Spontaneous spinal epidural hematoma. Report of two cases].
In the paper 2 cases of non-traumatic spinal epidural haematomas are presented. The possible aetiological factors--vascular malformation, coagulopathy, anticoagulants and neoplasm are discussed. Neurological state, diagnostic procedure and treatment are described. Taking into account our experience we state that only early diagnosis and operation-surgical decompression of spinal cord, could result in complete recovery.
Adult↗
[Thrombosis of the cavernous sinus].
The authors describe a case of cavernous sinus thrombosis in a female aged 59 years referred to hospital with suspected tumour at the base of the brain. With the present broad use of sulphamides and antibiotics the incidence of septic thrombosis of the cavernous sinus has decreased considerably. In the reported case the infectious focus giving rise to the thrombosis was in the palatine tonsils or in teeth with gangrenous changes. The thrombosis was associated with infarction of the left hemisphere. The correct diagnosis was established after CT of the head.
Anti-Bacterial Agents↗