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Biomedical subjects

T Trojanowski

Publications and source records attributed to T Trojanowski.

48 records · Page 3Linked to original sources
PubMedDate not supplied

[Surgical treatment of aneurysms of the anterior communicating artery using Yasargil's approach].

The results of surgical treatment in 19 cases of aneurysms of the anterior communicating artery from the approach described by Yasargil are described. In 16 patients the pedicle of the aneurysm was closed with a clip, in 2 cases the anterior communicating artery was excluded from the circulation by trapping, and in only 1 patient the aneurysm was enclosed in muscle and gazue. Control angiography demonstrated in 16 cases exclusion of the aneurysm from the circulation with maintenance of the patency of the main vessels, and in one case the sac of the aneurysm was partly shadowed. Good results were obtained in 80% of cases. One patient died (5%). Complications with development of Korsakoff's syndrome were observed in 3 patients (15%). The advantages of the approach described by Yasargil for the exposure and safe management of anterior communicating artery aneurysms are stressed.

Adolescent↗
PubMedDate not supplied

[New method for the experimental production of subarachnoid hemorrhage].

A new method for an experimental subarachnoid hemorrhage in a cat is described. It attempts to simulate closely a bleeding from a ruptured aneurysm. An approach through the mouth and presphenoid sinus offers to the internal carotid, cerebral anterior, media and anterior communicating arteries. Needle puncture produces local stress to the artery characteristic for aneurysm rupture. The bleeding occurs to the subarachnoid in a closed skull, since the bone opening untouched by the preparation. The method has been compared with other procedures for experimental subarachnoidal hemorrhage. The method is applicable to experimental studies on pathophysiological, metabolic and, vascular changes, after subarachnoid hemorrhage.

Animals↗
PubMedDate not supplied

[Giant osteoma of the skull].

A case of giant osteoma of the external lamina of the cranial bone is reported. The report is published as a contribution to the discussion on the methods of surgical removal of these tumours. The authors confirm the validity of the view that osteomas should be removed radically from the external lamina leaving the internal lamina intact if it is free of osteoma.

Adult↗
PubMedDate not supplied

[Early results of surgical treatment of chronic subdural hematoma in CT images].

Since the introduction of CT it has become possible to trace the pattern of brain changes after removal of subdural haematoma. Postoperative studies show frequently presence of haematoma residues, and this is connected with the problem of deciding about establishing of indications to reoperation, especially difficult if the patient is in a good clinical condition. The clinical status was compared with CT findings preoperatively and postoperatively in 20 patients subjected to operations for chronic subdural haematomas. A statistically significant correlation was found between the size of the mass effect in CT before and after the operation and the severity of the clinical condition. Major mass effect with high-grade ventricular shifting is more frequently connected with partially haemolysed haematoma in CT. The thickness of subdural haematoma exceeding 20 mm correlated with severe clinical condition, and increased the probability of hemiparesis persistence after the operation. Finding of residual haematoma in CT imaging after the operation, especially when not associated with high-grade mass effect, and with good clinical condition should not be accepted as an indication to repeated operation. In the presented material out of 15 patients with good clinical condition 12 had CT evidence of residual haematoma, and only one had reoperation in view of persisting evident mass effect.

Adult↗
PubMedDate not supplied

[Comparison of two treatment methods in inoperable primary brain tumors].

The results of two conservative treatment regimens in patients with inoperable brain tumours are presented. The group of 25 patients were treated with protracted telegammatherapy and concomitant multi-drug chemotherapy. Another group of 29 patients were irradiated with shorter series of increasing daily doses, receiving no chemotherapy. There was no statistical difference between survival curves of both groups of patients. The results indicate that irradiation with shorter series causes effects similar to protracted irradiation and allows reduction of treatment time by half.

Adult↗
PubMedDate not supplied

[The early results of surgical treatment of chronic subdural hematomas in computerized tomography imaging].

Since the introduction of computerized tomography (CT) it has been possible to trace the image of the brain after removal of subdural haematoma. Postoperative studies demonstrated often presence of residual haematoma. This raises the problem of establishing indication to reoperation, especially of patients with good clinical condition. The clinical condition and CT images before and after operation were assessed in 20 patients treated surgically for chronic subdural haematoma. A statistically significant correlation was found between the magnitude of the effect of the space occupying lesion in CT image and the severity of the clinical condition. A high-grade mass effect with major ventricular system shifting was more often connected with presence of partly haemolysed haematoma in CT. Subdural haematoma thickness exceeding 20 mm correlated with serious clinical condition of the patient, and increased the likelihood of hemiparesis persisting after the operation. Finding of residual haematoma in postoperative CT should not be an indication to reoperation, if not associated with high-grade mass effect and if the clinical condition is good. In our material out of 15 patients with good clinical condition postoperatively residual haematoma was detected by CT in 12 cases, but only one had to be reoperated because of persistent high-grade mass effect.

Adult↗
PubMedDate not supplied

[Direct effects of the intrathecal administration of normal saline for the brain expansion after the removal of subdural hematoma].

In a group of 360 patients the effects were studied of various management methods in case of lacking expansion of the brain after removal of chronic subdural haematoma on the therapeutic results. It was found that intrathecal infusion of normal saline was an effective procedure, with small frequency of transient complications, and was followed by a considerably lower number of re-operations than after external or internal drainage of haematoma cavity.

Adolescent↗
PubMedDate not supplied

[Spontaneous intracerebral hematomas in the material of the Department of Neurosurgery of Medical Academy in Lublin].

Between 1972 and 1991, 170 patients with spontaneous nontraumatic intracerebral haematomas were treated in the Neurosurgical Department of Medical Academy in Lublin. In 89 (52.5%) patients, the haematomas were caused by ruptured aneurysms; in 14 (8%), by angiomas; 67 (39.5%) haematomas had other etiology. Within the latter group of patients, 27% suffered from hypertension. Hypertension was also found in 15% of the patients with aneurysms and in 7% of the ones with angiomas. 34% of the haematomas were localized in the temporal lobe, 28%-in the frontal lobe, 3%-in parital lobe, 2%-in occipital lobe, 23% of haematomas were multi-lobal, 8% were found in deep brain structures, and in 2% haematomas were found in cerebellum. 128 patients underwent operative treatment, with a mortality rate of 26%, while 42 patients were treated conservatively, with a mortality rate of 19%. Basing on this material, the authors discuss indications for operative treatment of the haematomas.

Adult↗