[Value of the computer tomographic diagnosis of cerebellopontile angle tumors].
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Biomedical subjects
Publications and source records attributed to M Michalik.
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Computer tomography enables for the first time the direct demonstration of the consequences of a craniocerebral trauma. In the computer tomogram, the cerebral oedema is dominating as an area of reduced density (hypodense region). Three different measuring techniques are compared and their application in 43 craniocerebral traumata discussed. Among the measuring methods employed, the area index shows the greatest diagnostic reliability in the computer-tomographic findings of a posttraumatic cerebral oedema. The partial volume analysis without application of a contrast medium is of little use for computer-tomographic clearing of the question of a generalised cerebral oedema after SHT while the density index is only suitable in conjunction with additional parameters.
Thromboses of cerebral veins and sinus occur both in childhood and in adult age. The clinical symptoms are variable, so that until a few years ago the diagnosis had been based exclusively on angjiography. Owing to the introduction of computer tomography, a method has now become available to the clinician which, while it does not involve great risks and stress for the patient, is of great importance in the diagnosis of thromboses of cerebral veins and sinus, especially for the observation of the course of the disease and the therapy to be employed. This is particularly true of the indication for thrombolytic and anticoagulant therapy. The computertomographic findings are described on the basis of the literature and two own observations, differentiating between direct and indirect symptoms. All changes are inconstant, which makes the appraisal difficult. At the time being, the angiographic diagnosis can rarely be renounced. Both examination methods supplement each other very well.
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Today, the extension of the diagnosis of apoplexy by the employment of computer tomography is part of an important field of indications for this examination method. Experience in this respect could be obtained from a total of 1,500 patients with a share of 105 cases presenting cerebral blood supply disturbances. The unproblematic differentiation of mass haemorrhages and cerebral infarctions including the possibility of an exact assessment of the process dynamics proved to be diagnostically just as important as the differential diagnostics of intracranial haemorrhages of other origins, such as occur after a rupture of aneurysms and angiomas as well as tumour haemorrhages.
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In 12 patients with endogenous depression the longitudinal variations of the time of acrale reheating was measured. Under the treatment with Ouabain (g-Strophanthin) both the depth of depression and the time of acrale reheating was diminished between day 0 and 12.
In 7 healthy test persons and in 17 endogenous depressive patients the salivations rate was measured in a survey investigation with the SHP-test. The salivation rate of healthy test persons is constant. In endogenous depressive patients it develops a diminishing of depression depth under treatment with Ouabain (g-Strophanthin) between the 6th and the 12th day which is connected with reduction of the drive diminishing and the restauration of mood. The effective salivation rate is gaining. Possible principles of the influence of Ouabain are discussed.
On the basis of 70 serial angiograms of surgically and histologically reliably diagnosed intracranial meningiomas and the appertaining general radiographs of the skull the following was found: 48.5 per cent of the general radiographs showed reactions, 7.1 per cent showed tumour calcifications. Basal meningiomas of the anterior and medium cranial fossae and meniogiomas of the wings of the sphenoid bone are supplied by the a. carotis interna, that is to say, they are also diagnosed by the internal carotid angiography. In serial angiograms, classification was possible in 74 per cent. The other supratentorial meningiomas require angiographies of the external or the common carotid. Infratentorial menigiomas were diagnosed in 50 per cent of the angiograms. The "early vein" is no reliable sign of malignity of the menigiomas. The same applies to "apthologic vessels", "shunts", etc. Staining does not give any secure indications of histological structures.
UNLABELLED: First symptoms, period of case history, neurological findings and ophthalmological findings were evaluated in 123 patients operated on because of meningiomas. Typical first symptoms were headache (42%), fits (30%) and impaired vision (28%). 70 per cent of the patients showed a case history period of up to two years, 11 per cent one of more than five years. In 25 per cent this period was less than six months. In two cases the symptoms set in an acute form. Paresis was found in cases of meningiomas of the falx convexity region. A papilledema was found in 41 per cent, reflex differences in 30 per cent and hemiparesis in 13 per cent of the patients. LOCATION: parasagittal (28 patients), falx (10 patients), convexity (31 patients), tentorium (6 patients), posterior cranial fossa (4 patients). Neither a short period of the case history nor the absence of neurological and ophthalmological changes can exclude a meningioma.
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This is a clinical and pathological report on three cases (one 48-year-old male, one 57-year-old female, and one 59-year-old male) of neurocysticercosis where postmortem examinations were made between 1972 and 1974. In all of these three cases invasion of the body by the larva of Taenia solium and, more specifically, of the interpeduncular cisterns had led to chronic lymphocytic and granulomatous leptomeningitis and severe hydrocephalus. Complicating the disease picture in one case each were an occlusive granular ependymitis in the aqueduct and a nonspecific endangiitis. The great importance of liquor eosinophilia to the clinical diagnosis of neurocysticercosis is again demonstrated by reference to these cases. The complement fixation reaction is recommended as the most reliable method of diagnosing. This should be should in all ases of etiologically uncertain chronic leptomeningitis
Analysis of the neuroradiological diagnostics of 6 patients with hemi-basis syndrome. The significance of the different neuroradiological methods of examination are worked out, as well as their intended application, which is dependent on the clinical findings. Conclusions are drawn on the rapid and rational diagnostics.
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