Search PubMed⌕ Search

Biomedical subjects

M Tschabitscher

Publications and source records attributed to M Tschabitscher.

At least 37 records · Page 2Linked to original sources
PubMed1996

Endoscopic exploration of the IVth ventricle.

Regarding to the upcoming techniques in neuroendoscopy the IVth ventricle was examined. First in a series of 30 fresh and fixed anatomical specimens-the vessels injected with LATEX-the fourth ventricle was investigated endoscopically. There are three possibilities to reach the IVth ventricle: coming from the IIIrd ventricle via the aqueductus cerebri, using the basal cisterns through the apertura lateralis Luschkae and coming via the cerebellomedullar cistern through the foramen of Magendi. Using different kinds of endoscopes (rigid, flexible and steerable flexible)-diameter ranging from 5 to 9 french-with different optical systems (0 degree, 5 degrees, 30 degrees, 75 degrees) and different light sources (Halogen, Xenon) the anatomical details seen under the endoscope and the topographical landmarks of the approaches were investigated, presented and discussed. Based on the experience at the end of the cadaver work a short comment on which kind of equipment seems the best was given. A series of 14 clinical cases was presented as the second part of the study (7 cases with a tumor in the IVth ventricle-2 metastasis, 3 gliotic tumors, 1 ependymoma, 1 medulloblastoma, 3 patients with an occluded aqueduct because of meningo-ventriculitis and 4 patients with cystic malformations). The neuroendoscopic approaches, the neuroanatomical details relevant for surgery and the clinical data will be given and discussed. In general no intraoperative or postoperative complications were seen. In conclusion our experience from the theoretical neuroanatomical and the clinical part as well as the advantages and disadvantages from the different kind of endoscopes and approaches are discussed.

Adult↗
PubMed1996

Formaldehyde and phenol exposure during an anatomy dissection course: a possible source of IgE-mediated sensitization?

The sensitizing potency of formaldehyde and phenol exposure during 4 weeks of an anatomy dissection course was assessed in 45 medical students. Specific IgE against formaldehyde by RAST and by ELISA and specific IgE against phenol by ELISA were assessed before and after the course. At the start of the course, symptoms, type I allergy, respiratory diseases, and smoking habits were noted. At the end of the course, only symptoms experienced during the dissection lessons were assessed. Indoor formaldehyde levels were measured continuously. The mean indoor formaldehyde level was 0.124 +/- 0.05 ppm, with a minimum of 0.059 ppm and a maximum of 0.219 ppm. Specific IgE against formaldehyde or phenol was found in none of the subjects at the beginning of the course, and no student showed specific IgE against formaldehyde or phenol after the course. Assessment of primarily irritant symptoms during the lesson revealed itch and paraesthesia of hands in 33/45 students (P < 0.00005), headache in 15/45 students, burning eyes in 13/45 students (P < 0.02), dizziness in 8/45 students (P < 0.008), sneezing in 4/45 students, epistaxis in 2/45 students, and shortness of breath in 1/45 students. According to our data, 1-month exposure to formaldehyde and phenol during an anatomy dissection course does not induce specific IgE against formaldehyde or phenol.

Adolescent↗
PubMed1996

Surface and superficial surgical anatomy of the posterolateral cranial base: significance for surgical planning and approach.

We have performed an anatomic study, 15 using fixed cadaveric preparations, with the goal of identifying surface landmarks that will reliably locate the underlying transverse and sigmoid sinus complex. Simple morphometric relationships were first determined on both sides of each specimen to yield 30 sides measured. The following relationships were determined: 1) zygoma root-asterion, 2) asterion-mastoid tip, 3) zygoma root-suprameatal spine (Henle's spine), 4) asterion-suprameatal spine, 5) mastoid tip-suprameatal spine. The relationship of the asterion to the transverse-sigmoid junction was determined by bone removal. Also, the distances from the asterion to the sigmoid sinus-superior petrosal sinus junction and the superior margin of the transverse sinus were studied. Surface and marks were found to have definitive relationships to underlying anatomic substrates in all specimens studied. The critical relationships that were concluded from this study can be described in terms of two easily identified lines between bony surface structures. A line drawn from the zygoma root to the inion, i.e., the superior nuchal line, reliably located the rostrocaudal level of the transverse sinus in all specimens. Although the asterion did not consistently fall on this line, the transverse-sigmoid junction could reliably be placed at the anteroposterior level of the asterion. Further, a line drawn from the squamosal-parietomastoid suture junction to the mastoid tip reliably defined the axis of the sigmoid sinus through the mastoid. We also found that the junction of the squamosal and parietomastoid sutures lay over the anterior border of the upper curve of the sigmoid sinus. The anterior portion of the supramastoid crest correlated with the level of the middle fossa. These surface relationships all have significance for posterolateral approaches to the cranial base. Since performing this study, these relationships have been found reliable for operative planning in our clinical cases.

Cephalometry↗
PubMed1995

Neuroanatomical details under endoscopical view--relevant for radiosurgery?

Both, neuroendoscopy and radiosurgery, are upcoming techniques in neurosurgery and become nowadays more and more important. In planning radiosurgical interventions it is very important to have both, the information about the morphology of the pathology itself, and also a clear understanding from the surrounding structures. Neuroendoscopic techniques gives the possibility to demonstrate well known structures without prior dissection. This paper focuses on these anatomical informations which might be relevant in planning further radiosurgical interventions especially in cases of the vascularization of the cranial nerves and the arachnoid membranes, these structures appears much more complex than described in "common" neuroanatomical textbooks. Endoscopic techniques also better demonstrate the real in vivo relationships and gives so a better understanding for interpreting "planning" MRI and CT scans. We therefore consider that neuroanatomical studies under a neuroendoscopical view are very important and could be very helpful in planning radiosurgical intervensitons.

Arachnoid↗
PubMed1995

Endoscopically assisted microneurosurgery.

Technological developments in neuroendoscopy are leading to an expansion of applications into the realm of microneurosurgical procedures. The new dimension that using an endoscope provides requires insight into different neuroanatomical aspects and a new kind of strategy in planning a microneurosurgical procedure. To gain some new insights into these exciting aspects of neurosurgery we have explored the sellar, parasellar, and posterior fossa regions in 50 fresh anatomical specimens and used various types of endoscopes to observe the surgically relevant neurotopographical details. We then utilized this experience in 33 clinical cases during microsurgical approaches for various lesions (posterior fossa tumors - 12 cases, sellar and parasellar tumors - 8 cases, trans-sphenoidal procedures for pituitary adenoma - 7 cases, transventricular procedures - 6 cases). In the laboratory we found that familiar neuroanatomical structures are seen in a completely different aspect from what we are accustomed. Orientation is at times difficult, which requires rehearsal and special handling of the endoscope for complex clinical procedures. We found that certain structures that are hardly noticed in routine anatomical views become very important when utilizing the endoscope (i.e., different arachnoid membranes and trabeculae). Importantly, the dimensions of a microsurgical approach can be greatly enlarged with the endoscope, making it possible to look behind structures and ''around corners''. We present our findings with respect to important anatomical details relevant to utilizing the endoscope as an adjunct to microneurosurgical procedures and our clinical data. We have concluded that the neuroendoscope can be a safe and helpful adjunct in many microneurosurgical procedures.

Endoscopy↗
PubMed1994

Endoscopic anatomy of the ventricles.

The endoscopic view offers a new anatomical dimension to the neurosurgeon. The fact makes it basically necessary to study the topographic anatomy under endoscopic conditions. In this paper attention was drawn to the ventricles because they are the most common region of clinical application. In 25 specimens neuroendoscopic explorations of the ventricles have been done. The dissections have been carried out through one- and two burr hole approaches (two working endoscopes at the same time). The instrumentation includes rigid 4 mm and 6 mm endoscopes. The procedures have been documented by continuous video recording and parallel photography.

Cerebral Ventricles↗
PubMed1993

Difficulties in examination of the origin of the vertebral artery by duplex and colour-coded Doppler sonography: anatomical considerations.

Despite progress in ultrasonographic techniques visualisation of the origin of the vertebral arteries, particularly the left, by duplex and colour Doppler imaging, still poses a problem in a significant number of patients. In anatomical and radiological studies we demonstrated an anomalous origin in 6%, the left vertebral artery originating directly from the aorta in most cases. The origin from the subclavian artery was found to be posterior in 44% and inferior in 6%. The V1 segment of the vertebral artery (from its origin to the entry into the foramen transversarium) was tortuous in 47% of cases. These anatomical variants and variations in the course of the vessel contribute to the nonvisualisation of the origin of the vertebral artery by duplex and colour Doppler imaging. With respect to tortuosities technical modifications for better visualisation are suggested and possible implications for surgery are discussed.

Aged↗
PubMed1992

The termination of the vein of "Labbé" and its microsurgical significance.

Information about the termination of the inferior anastomotic vein of Labbé is of crucial importance in the subtemporal neurosurgical approach and its modifications. An intradural course has been observed in all cases. The vein of Labbé reaches in 3/4th the anterior third of the transverse sinus, in 73% of all cases tracing a so-called tentorial sinus. By dissecting the vein of Labbé out of its dural bed and shifting its fixation point, microsurgical access is facilitated considerably.

Cerebral Veins↗
PubMed1991

Modifications of temporal approaches: anatomical aspects of a microneurosurgical approach.

All subtemporal approaches have in common the risk of temporal lobe damage. To reduce the retraction of the temporal lobe we combine two synergistic modifications of temporal approaches to reach the prepontine space. The first is the temporary resection of the zygomatic arch which allows to bring the temporalis muscle more caudally and subsequently allows an anterior subtemporal approach with only minimal temporal lobe retraction. The second modification is the resection of the apex of the petrous bone after incision of the tentorium. This provides an excellent view into the posterior fossa between the trigeminal nerve medially, the internal carotid artery caudally and the internal auditory canal laterally. The anatomical aspects of a microneurosurgical approach regarding these modifications are reported and discussed.

Brain Neoplasms↗
PubMed1991

[The intermediary nerve at its entry and exist site in the brain stem].

On 119 brain stem halves the nerve root fasciculi of the intermediary nerve were examined in respect of their position relative to the facial and vestibulocochlear nerves. The following variants were seen: 1.) the intermediary nerve lies between the facial and vestibulocochlear nerves as stated in the textbooks, in 32.9% of the cases; 2.) in 18.5% of the cases it is entirely apposited to the vestibulocochlear nerve from the beginning and branches off from that nerve only later; 3.) part of the nerve root fasciculi are apposited to the vestibulocochlear nerve and the others originate between the facial and vestibulocochlear nerves. This was seen in 49.6% of the cases.

Brain Stem↗
PubMed1991

Course of the arteria vertebralis in its segment V1 from the origin to its entry into the foramen processus transversi.

The segment V1 of the arteria vertebralis (pathway from its origin from the a. subclavia to the entry into the respective foramen processus transversi) has a special significance in vascular surgery. Contrary to indications in the literature, we found 47.15% of the specimens to have a contorted course in this segment. The tortuosities carried by the respective vessels were found to be horizontal in 42.5%, in a sagittal direction in 30% and in the frontal plane in 27% of the cases. However, no significant difference was found between vessels carrying a tortuosity and those without, regarding the average lengths of the arteries concerned in the segment V1.

Aged↗
PubMed1991

[The variations in the origin of cranial nerves III, IV and VI].

In 100 human brains the spot and the mode of emergence of the 3rd, 4th and 6th cranial nerves where investigated. In analogy to spinal nerves a fusion of Fila radicularia to roots and of roots to the complete nerves could be described. For the 3rd nerve 3 types had to be distinguished: in 21% there was only 1 root, in 71% there were 2 roots, one of which emerged from the Sulcus n. oculomotorii and the other from the Crus cerebri and in 8% 2 roots formed a tong embracing the medical part of the Crus cerebri. The number of rootlets of the 4th nerve varied from 1 to 5; most frequently--in 45%--there were 2. The 6th nerve shows 3 types: in 46% 1 root, in 47% 2 roots and in 7% 3 roots.

Abducens Nerve↗
PubMed1990

The persistent trigeminal artery and its topographical relations.

The topographical relation of a persistent trigeminal artery (PTA) to neighboring structures was investigated. The vessel belongs to Saltzman's type I. It originates from segment C5 of the internal carotid artery and opens into the basilar artery, 8 mm before the bifurcation into the two posterior cerebral arteries. The 6th cranial nerve winds around the first part of the PTA which is situated within Parkinson's triangle.

Aged↗
PubMed1989

[The arterial supply of the muscle biceps brachii].

The bicipital arteries (Rami bicipitales) were classified according to the part of the muscle they supply, to the artery from which they originate and to their relative position to the median, musculocutaneous and ulnar nerves. The maximal density of bicipital arteries can be found in the middle of the upper arm and slightly distal to the greater tubercle.

Arteries↗
PubMed1989

[Hydatid torsion as a cause of acute scrotum--clinical, sonographic and anatomic aspects].

Out of 82 patients with acute swelling of the scrotum, 25 (30.5%) had hydatid torsion. Hydatid torsion was the second most common cause of acute scrotal swelling in the entire patient group. In the group of patients up to 14 years of age (n = 36), hydatid torsion was found in 47.2% and was the most common cause of acute scrotal swelling, followed by torsion of the spermatic cord. Only 3 patients had torsion of an appendage of the epididymis. All other patients (n = 22) had torsion of the hydatid of Morgagni (appendage of the testicle). A difference in anatomical structure and vascularization during childhood seems to be the most important aspect regarding hydatid torsion and hemorrhagic infarction. Ultrasonographic examination of the scrotum and checking to see if the typical physical signs are present can help in making the exact diagnosis. In 13 patients with hydatid torsion, the scrotum was examined with ultrasound high-frequency transducers (7.5, 10 and 12 MHz). In 4 patients, the diagnosis was hydatid torsion, as determined by ultrasonography. Two patients were treated conservatively with a daily follow-up including a clinical examination and investigation of the scrotum with ultrasound. The patients recovered very quickly and the acute symptoms resolved within a few days in virtually all instances. Thus, in cases where the diagnosis is proven and the course of the disease is reasonably mild and painless, conservative management of intrascrotal hydatid torsion is possible and can be an effective means of treatment in lien of surgical intervention.

Acute Disease↗
PubMed1985

[The superficial brachial artery].

100 right and 100 left upper limbs were prepared. In 83% a normal A. brachialis was found, whereas in 17% there existed an A. brachialis superficialis, which in 6% was an A. brachialis superficialis superior, in 1.5% an A. brachialis superficialis media and in 9.5% an A. brachialis superficialis inferior. The relation of those 3 main types of A. brachialis superficialis to the arteries of the forearm was examined and the percentage of each possible type of relation is indicated.

Arm↗
PubMed1985

Transsylvian approach to the tentorial hiatus--anatomical remarks on the microsurgical exposure.

A. The transsylvian approach: 1. Splitting of the arachnoid frontally to the medial superficial cerebral vein. 2. Incision of the arachnoid from laterally to medially. 3. Deep dissection frontally to the branches of the middle cerebral artery. 4. Cutting of medial and lateral bridging veins. 5. Spreading of the sylvian fissure. 6. Depending on the length of the intraarachnoidal part of the internal carotid artery and of the posterior communicating artery the alternatives are either subfrontal or subtemporal. B. Through this approach, access to the rostral half of the tentorial hiatus is possible. Also structures which are contralateral to the craniotomy can be reached.

Arteries↗