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Biomedical subjects

O Gratzl

Publications and source records attributed to O Gratzl.

118 records · Page 7Linked to original sources
PubMed1976

Clinical experience with extra-intracranial arterial anastomosis in 65 cases.

Clinical results of an extra-intracranial arterial bypass (EIAB) procedure for cerebral ischemia are assessed in 65 patients. The 5-year-study suggests that the EIAB procedure has a protective effect against further clinically significant cerebrovascular accidents in properly selected patients. Correlation with angiography and regional cerebral blood flow (rCBF) studies are discussed. It is felt that rCBF measurements offer the best diagnostic test to determine which patients are suitable for surgery by revealing if an ischemic or relative ischemic focus is present. The surgical procedure is contraindicated in acute cerebral ischemia and when the rCBF study reveals general reduction of cerebral blood flow as opposed to a localized ischemic focus.

Adult↗
PubMed1976

[Ultrasonic doppler technique for microvascular bypass (author's transl)].

Following an operative microvascular extraintracranial bypass, 50 patients were re-examined by the ultrasonic Doppler technique. The findings were compared with the results achieved by post-operative angiography. This examination of the patency of extraintracranial anastomoses with the ultrasonic Doppler technique can be conducted on an outpatient basis, is noninvasive and can be frequently repeated. It has a high degree of accuracy (96%). In addition, there were indications that, in certain areas, a gauge could be established for the function of the anastomosis by comparing the amplitude indices from the bypass and the afferent vessels. Key-words: Ultrasonic Doppler technique - microvascular bypass - cerebral blood flow - cerebrovascular disorders

Cerebral Angiography↗
PubMedDate not supplied

Severe head injury: should expected outcome influence resuscitation and first-day decisions?

An early 'prognosis' based on initial findings can influence clinical decisions. To evaluate the quality of first-day outcome prediction based on either clinical or neuroradiological information, we prospectively examined 100 consecutive severely head-injured patients from the surgical intensive care unit. The prognoses were always made by the same experienced neurosurgeon and neuroradiologist according to a contracted Glasgow Outcome Scale (GOS). Every patient's outcome was predicted according to a three-class GOS within 24 h after injury. Correct 'first-day' prognoses were made in 59 and 56% of the cases by the neuroradiologist and neurosurgeon, respectively. In those instances where the prognoses made by the clinician and the radiologist coincided, the prognoses were correct for 73% of the patients. Based on accepted criteria, the neuroradiologist tended to overpredict favorable outcomes and missed many of the unfavorable outcomes (dead or vegetative) whereas the clinician overestimated unfavorable outcomes. Our study showed that outcome prognosis of patients with severe head injury has limited accuracy when made within 24 h after the injury, although an improvement in accuracy occurred when there was agreement between clinical and radiological predictions. Even with sophisticated clinical and radiological technologies, it is not possible to predict outcome on the first day after the accident with sufficient accuracy to guide early management.

Adult↗
PubMedDate not supplied

Computer aided surgery with special focus on neuronavigation.

The term computer aided surgery (CAS) is now mainly used for an intraoperative navigation within the body combining a 3D-digitizer with preoperative CT/MR-imaging. This method has become indispensable in neurosurgery for the removal of deep-seated and/or critically located intracranial tumors and vascular malformations. Also ENT surgery within the paranasal sinuses and setting of pedicle screws in orthopedic surgery profit greatly from the high targeting precision of CAS. And still a growing number of surgical disciplines are employing this method. Today infrared-optical 3D-digitizers are state of the art, but electromagnetic spatial digitizing using novel, miniature localizers is promising, too. The results of our CAS study 1994-mid-1997 with 50 patients suffering from small intracranial lesions are presented.

Adolescent↗
PubMedDate not supplied

Transluminal angioplasty of stenotic carotid arteries: case reports and protocol.

Transluminal angioplasty of the carotid artery was successfully performed without complications in two patients, one with a stenotic internal carotid artery and one with a stenotic common carotid artery. Effectiveness of the procedure was proven by amelioration of common carotid flow. The authors outline factors to be considered in selecting patients for this procedure, including the particular cerebrovascular pathogenesis, type of stenotic lesion, clinical indications, and technique and materials used for dilatation.

Angioplasty, Balloon↗