Biomedical subjects
M Sramka
Publications and source records attributed to M Sramka.
[Ablation of nerve structures with the aid of spreading depression in neurosurgical operations].
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[The phenomena of kindling and anti-kindling under clinical conditions].
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Combined transtentorial dentatotomy with pulvinarotomy in cerebral palsy.
For frequently associated spasticity with involuntary movements in cerebral palsy operations on cerebellar nuclei or on the pulvinar of the thalamus are recommended. We combined both approaches in 45 patients. The combination was possible after experiences with transtentorial dentatotomy, in which the electrodes are introduced into the deep structures of the cerebellum from a burr-hole on the lambdoid suture. The same lambdoid approach may equally well be applied for introducing electrodes into the pulvinar of the thalamus. The lesion in the pulvinar may moreover be combined with the target in the centrum medianum or in the nuclei VIM-VCP or VOP. Lesions are always asymmetric and multilocular. Their influence on the clinical picture is quite favourable.
[Standardizarion of stereoelectroencephalographic examination in epilepsy].
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Contribution to surgical terminology in epilepsy.
The classifications of the World Health Organization used in epileptology do not contain any aspects of surgical treatment. The introduction of stereotactic techniques make it necessary to include in the classification such terms as multifocal epilepsy, modified epilepsy and iatrogenic epilepsy. Epilepsy classification will most likely be affected also by the neuro-histological changes found from epileptogenic zones with bio-chemical analysis of brain structures as well as from the zone of epileptic focus.
Effects of stereotactic operations in the treatment of epilepsies--neurological aspects.
In 81 patients with intractable epileptic seizures 121 stereo-electroencephalographic (SEEG) examinations and 91 operations with stereoencephalotomy (SET) were carried out. SEEG and SET targets were chosen in 22 different subcortical structures and in the medial frontal cortex. In 6 of 18 temporal epilepsy cases SET was followed by classical hippocampectomy. With the exception of temporal lobe cases all others were unsuitable for classical neurosurgery. Of 61 controlled patients 24.5% were cured or greatly improved cured, 39.5% improved and 36% unimproved; Correlations among the clinical, EEG and SEEG findings; SET and therapeutic effects are discussed together with the role of stereotactic procedures. In our experience (Cigánek 1962) among patients unsuccessfully treated by conservative methods over 60% are unsuitable for classical procedures based on the criteria of the Montreal neurosurgical school, because of the absence of leading epileptogenic area or because they represent cases with completely or almost completely generalized seizures. In these cases stereotaxy offers prospects diagnostic refinement and treatment.
Some observations in treatment stimulation of epilepsy.
In a group of 10 patients suffering from epilepsy therapeutic stimulation was applied by means of chronic electrodes and a technical stimulator three times in nucleus dentatus, five times in nucleus caudatus, once in both structures simultaneously. Once chronic electrodes were introduced into the amygdalo-hippocampal complex and non-specific thalanic system bilaterally. One patient was stimulated by means of a pacemaker and once by normal rhythm from the hypothalamus of the same patient using magnetic tape. The patients were subjected to stimulations once a day for a period of 1-8 days. The results obtained are being discussed with respect to Goddard's kindling phenomenon.
Graphic representation of the epileptic focus.
On the basis of systematic examinations of electrical activity of brain deep structures in 87 epileptic patients, an experiment was carried out to replace the concept of the epileptic focus by the graph of functional grouping of structures with epileptic activity. In order to make the graph as realistic as possible, the multi-lead electrodes have to be introduced into the brain systematically and under standard conditions. In this case, the results obtained are comparable. At the same time, the graph proves to be the basis of indications for stereotactic treatment.
[Pulvinarotomy as a new method in treating derangements of motor activity (author's transl)].
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[Stereobiopsy (personal experiences)].
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[Compulsive hedonsim syndrome (author's transl)].
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Formation of glutamate and GABA in epileptogenic tissue from human hippocampus in vitro.
The levels of some amino acids and the incorporation rates of 14C from glucose and acetate were estimated in control human brain tissue and epileptogenic foci from human hippocampus incubated in glucose-saline medium. In the epileptogenic tissue the level of glutamine and the incorporation of radioactivity from both substrates into glutamine were lowered, mainly from acetate. These results suggest damaged glial metabolism. The relative increase of glutamate and decrease of glutamate formation in epileptogenic tissue were similar to the changes caused in rat brain slices by increased concentration of potassium in the incubation medium.
Investigation of epileptic structure properties by transfer function.
The paper deals with the possibility of applying linear control theory and the theory of statistical dynamics to the complex and quantitative analysis of electroencephalographic records. The aim is to specify signals in the brain environment, in particular sources, speed and direction of signals, and the determination from results gained of the model of signal transfer, The possibilities of applying Fourier analysis and correlation analysis are examined. The methodical approach of the transient analysis is suggested. Conditions are discussed for approximate application of linear theory. Experimental results, as well as the calculation of transfer parameters of signals are evaluated. The method of magnetic EEG records, the scanning and processing of data on analogue and digital computers are introduced. The method described of correlation and transient analysis arises from the necessity to detect epileptic structures from an evaluation of SEEG records of the deep brain structure.
Contemporary methodology of stereotactic neurosurgery.
A survey of stereotactic operations from neurosurgical centres, one in Madras and the other in Bratislava, shows that many stereotactic operations are of the combined type. From a methodological viewpoint, stereotactic preformances may be divided into simultaneous, successive, symmetrical, asymmetrical, and one-sided, respectively. Thus, the stereotactic operation differs from the traditional concept that the patient may be cured by a single surgical performance. The stereotactic treatment usually consists of a succession of tactical steps, which make up the strategy of the whole treatment.
Surgical complication of posterior hypothalamotomy.
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[Critical views on the stereotactic treatment of epilepsy].
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[Significance of deep-implanted chronic electrodes for the determination of an epileptic focus].
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