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Biomedical subjects

O Gratzl

Publications and source records attributed to O Gratzl.

At least 109 records · Page 6Linked to original sources
PubMed1984

[Ultrasonic resection of brain tumors].

With the CUSA Ultrasonic Aspirator even consistent tumors can be removed with a minimum of tissue traction and almost entirely sparing the adjacent neural and vascular structures. The hand guided titanium tip oscillates at 23 kc and disintegrates the pathological tissue aspirating it continuously through a central channel. Particularly in neurosurgery, where in many instances resection has to be carried out transtumorally this instrument has proved to be of great help. Three cases of large brain tumors are presented in which the CUSA technique allowed an easy and rapid removal of the neoformation with a minimum of blood loss.

Aged↗
PubMed1984

[Lumbar intervertebral disk prolapse in adolescence. I. Clinical observations].

Twenty-five cases of intervertebral disc herniation in young people between 15 and 25 years old are reported. They have been operated in the Neurosurgical Clinic of Basle between July 1978 and July 1982. The clinical and radiological findings, the operative procedure and the results are described. The postoperative courses were generally more complicated in the young than in a comparative group of elder patients. The importance of strict, restrictive indications for this operation is pointed out.

Adolescent↗
PubMed1983

[Results of the surgical treatment of cervical disk hernia and myelopathy with dorsal approach].

Between 1978 and 1981 68 patients underwent posterior surgery on the cervical spine at the Neurosurgical Clinic of Basle. In 24 patients the radicular compression syndrome was caused by a soft disc herniation and in 25 patients by degenerative changes of the cervical spine (hard discs). In 19 patients a cervical myelopathy was caused by a narrowing of the spinal canal. After 1-4 years follow-up the results were excellent or good in more than 90% in soft discs, 80% in hard discs and less than 40% in spinal canal stenosis. The advantages and inconveniences of the different approaches and operative methods are discussed.

Adult↗
PubMed1983

STA-MCA bypass: results 10 years postoperatively.

The STA-MCA (superficial temporal artery-middle cerebral artery) bypass has become increasingly popular in the treatment of cerebral vascular disease. Indication and assessment of postoperative results have been based on clinical grounds and on findings from cerebral angiography (10). In order to obtain objective data, regional cerebral blood flow studies have been performed pre- and postoperatively in our institution since 1971 (5, 6, 12). The value of the bypass procedure is still controversial. The results of a multicenter cooperative study are not yet available. It is the purpose of this article to give the first report of a 10-year follow-up after bypass and to reevaluate the selection for bypass surgery.

Adult↗
PubMed1983

[Results of the first hundred cerebral bypass operations in Basel].

This is a report on clinical findings after 100 extra-intracranial bypass procedures for cerebral ischemia. The patients presented with transient ischemic attacks, prolonged ischemic neurological deficits, completed strokes, low perfusion syndromes and ischemic ocular diseases. The microvascular anastomosis is performed between a branch of the external carotid artery and a cortical branch of the middle cerebral artery. In 10 patients we performed a bilateral bypass. We had no mortality. The morbidity was 5%, the patency rate 96%. The effect of the microvascular procedure can be determined by comparing the postoperative follow-up (averaging 22 months) and the natural course of cerebrovascular disease. Clinical benefit is gained in the elimination of transient ischemic attacks. Patients considered candidates for diagnostic studies are those presenting with completed strokes. Finally in patients with large aneurysms extra-intracranial bypass procedures may prove to be of value, when carried out in a combined approach.

Adult↗
PubMed1982

Morphological and clinical analysis of extra-intracranial bypass. 1. Clinical and angiographical analysis.

In this morphological-clinical analysis it was possible to study the clinical and angiographical results of extra-intracranial bypass in a continued series. Small changes in management result from the indications in the groups with TIA's and completed strokes. Preoperative angiographical findings allow determination of the most favourable bypass-feeder taking into consideration age and morphology. From the postoperative dilatation of the donor artery conclusions may be drawn as to the indication for operation with respect to the angiogram and the choice of the branch of the superficial temporal artery.

Adult↗
PubMed1982

Morphological and clinical analysis of extra-intracranial bypass. 2. Histological and histometrical evaluation with correlation of angiographical findings.

Rest segments of superficial temporal arteries obtained during STA-MCA anastomoses were studied histologically and histometrically. Aging was found to be associated with thickening of the intimal layer and thinning of the medial layer. In comparison with the young patients, the old patients showed a larger internal diameter of the superficial temporal artery and a larger ratio of the thickness of the intimal layer to the medial layer. The internal diameter calculated angiographically and the internal diameter estimated histologically correlated well. The dilatation ratio of the superficial temporal artery did not correlate with dimensional data assessed histologically.

Adult↗
PubMed1981

[Cerebral ischemia. Possibilities and limitations of neurosurgical treatment (author's transl)].

The construction of a new collateral circulation between the external carotid artery and a cortical ramus of the middle cerebral artery is a prophylactic measure in patients with a lesion in the distal arterial cerebral circulation by which the appearance of further symptoms, and especially the development of a complete apoplexy can be prevented. This is confirmed by the results with 300 patients. In the light of clinical criteria and additional methods of investigation, particularly cerebral angiography and computer, tomography, the indications for the operation are discussed.

Brain Ischemia↗
PubMed1979

[Operative therapy of malignant intracranial tumors by the CO2 laser. Initial results after vaporization of the tumors].

From the Clinic of Neurosurgery of the Kantonsspital Basle a report is given over a one year-experience with a CO2-Sharplan 791 Laser (Prod.: Laser Industrie Ltd., Israel). The excellent technical qualities, as described by other authors, have been confirmed. 11 patients with malignant glioma received all the same treatment (intratumoral partly resection and "vaporisation" of the tumor-bed with Laser-ray followed by radiotherapy with 6000 rad.). It showed that the post-operative course and the definite prognosis of the disease is not decisive different from the results of an operative treatment with conventional methods. Only 2 (18,1%) patients were in a satisfactory condition fourty weeks after operation and radiotherapy. 5 patients (45,4%) died in the first 10 months after operation and radiotherapy and 4 (36,3%) had a relapse 6 months after surgical intervention.

Adult↗
PubMed1976

Regional blood flow measurement in extra-intracranial anastomoses for cerebral ischemia. Methodologic aspects.

The value of regional cerebral blood flow measurement for the microneurosurgical treatment of cerebral ischemia is outlined. Preoperatively, this method is of great value for the selection of suitable candidates for this operation. Postoperatively, the effect of the extraintracranial arterial bypass on the ischemic brain may be quantitatively assessed. The practical management of flow measurements in these patients is discussed.

Adolescent↗
PubMed1976

Selection of patients for extra-intracranial arterial bypass surgery based on rCBF measurements.

Extracranial intracranial arterial anastomosis is gaining acceptance as a form of treatment in selected cases with ischemic cerebrovascular disease. To establish indications for this operation and to provide an objective assessment of postoperative results, regional cerebral blood flow (rCBF) studies were performed in 110 patients with cerebrovascular insufficiency considered for extra-intracranial bypass surgery. The 133Xe intracarotid injection method with 16 externally placed detectors was used for measuring rCBF. Postoperatively, rCBF was measured in 40 patients. From these results our present criteria for surgery have evolved. The probability of a good postoperative result is best in patients who showed focal cerebral ischemia or a moderate general reduction of CBF with an additional ischemic focus. The operation is contraindicated in patients with either normal or severely reduced CBF values (less than 60% of normal).

Adult↗