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Biomedical subjects

U Ebeling

Publications and source records attributed to U Ebeling.

48 records · Page 3Linked to original sources
PubMed1986

[Acute space-occupying processes in the posterior cranial fossa. Clinical aspects and computerized tomographic findings].

Ascending transtentorial herniation and compression of the brain stem are very severe sequelae of acute space-occupying lesions of the posterior fossa such as hematoma, infarction and tumours. The symptoms, course and outcome of these acute space - occupying lesions are discussed on the basis of 50 patients. For correct diagnosis of transtentorial herniation, CT studies are essential. The signs can be divided into early and alarming, and the time course into a biphasic and foudroyant form. Early detection of transtentorial herniation or impending incarceration is of crucial importance for successful therapy.

Acute Disease↗
PubMed1986

Localization of the precentral gyrus in the computed tomogram and its clinical application.

In 30 patients the anatomical configurations of the precentral and central sulcus and gyrus were examined by computed tomography and could be determined with great accuracy. The distances between the coronal suture and the central and precentral fissure, and the angle between the longitudinal fissure and the central fissure were measured. These data are used in the precise localization for a surgical approach to a mass lesion.

Humans↗
PubMed1986

Results of microsurgical lumbar discectomy. Review on 485 patients.

485 patients with a lumbar disc herniation were operated upon microsurgically. The results, the rate of complications and true recurrent herniations will be presented. The results of the microsurgical technique are compared to the results of the conventional technique. The final outcome after the microsurgical operation was excellent in 39%, good in 34% and satisfactory in 19%, 9% of the patients had a poor final outcome. The results obtained with microsurgery are attained with the standard techniques only by few groups, probably highly experienced surgeons. Following microsurgery a uniformly high percentage (88-98%) of results are reported as being satisfactory, whereas the analogous figures range between 40 and 98% following the standard technique.

Adolescent↗
PubMed1986

Nimodipine and early aneurysm operation in good condition SAH patients.

A prospective open multicenter study on the preventive effect of nimodipine on symptomatic vascular spasm was performed in 120 (consecutive) patients with aneurysmal subarachnoid haemorrhage (SAH). All patients underwent early surgery (i.e. within 72 hours post SAH) and were in neurological grades I-III in Hunt and Hess. Grade IV and V as well as patients with significant intracerebral haematoma are not included. On preoperative CT, SAH was mild in 28 cases, moderate in 56 and severe in 36 cases. 25 patients (21%) were in grade I, 63 patients (53%) in grade II and 32 patients (26%) in grade III. The ruptured aneurysm was located on the anterior cerebral artery complex in 57 patients, on the internal carotid artery complex in 35, on the middle cerebral artery in 24 patients and on the basilar artery in 4 patients. After occlusion of the ruptured aneurysm, the lipophilic calcium channel blocker nimodipine was administered in the following manner: Intraoperative, topical irrigation of the exposed arteries. Intravenous infusion until day 7-14 after SAH followed by peroral medication for another week. Nimodipine was well tolerated and neither significant hypotension nor any other adverse reaction attributable to the drug was observed. Ischaemic cerebral dysfunction of delayed onset with permanent neurological deficit occurred in 2 patients (2%). Another 8 patients showed transient ischaemic symptoms. At 6 months follow-up, 93% of the patients were classified as having made a full recovery, 16% as being minimally disabled, 5% as being moderately disabled and 3% as being severely disabled. Three patients had died. The present study supports the concept that preventive nimodipine treatment may reduce delayed ischaemic deficit in early aneurysm surgery.

Administration, Topical↗
PubMed1983

[Results of microsurgical lumbar intervertebral disk operation. Preliminary report].

Since the end of 1977 we have introduced the microsurgical discectomy according to the technique of Caspar. The results of 150 consecutive patients have been analysed. The preliminary results of these patients will be presented. The microsurgical and conventional technique were evaluated and compared concerning the size of the operation, complications, recurrent herniations and the outcome. In 84% of our patients a selective monosegmental approach could be performed. A hemilaminectomy was necessary only in 1.3% of the patients. In 96% the discectomy could be restricted to one level. Thus, traumatisation of back musculature and bone resection was markedly less than with the conventional technique. The frequency of complications with the microsurgical technique was significantly lower. The frequency of repeat operation (arachnitis, true repeat herniation) did not differ essentially. Concerning the outcome of operation the results of the microsurgical technique seems to be more favourable. The frequency of bad results did not differ.

Adult↗
PubMed1983

[Diagnosis and therapy of lateral intervertebral disk displacements. I. Normal roentgen anatomy of the lumbar nerve roots in computer tomography].

As a basis for the CT diagnosis of lateral disc herniations, the normal anatomy of the nerve roots from L4 to S1 within the lateral recess, is described and compared with the myelographic and CT findings. In myelograms, the roots can be demonstrated from where they leave the dural sac, for about the height of one vertebral body as far as the spinal ganglion in the upper part of the intervertebral foramen, where the subarachnoid space terminates. By non-enhanced CT, the roots can be distinguished from the surrounding fat only in the widening lower part of the lateral recess. The ganglion and the spinal nerve can be shown in the intervertebral foramen and further distally where they can no longer be seen on the myelogram,. Thus, of both these complementary techniques, CT s more suitable for the diagnosis of lateral disc herniations.

Humans↗
PubMed1983

[Diagnosis and treatment of lateral disc herniations. II. Classification, pathomechanical aspects of development, radiological demonstration, and operative approach].

Lateral disc herniations can be classified into three types according to their location. Type I is a prolapse within the lateral recess. In myelograms, it compresses the lateral part of the dural sac and the adjacent nerve root which is running to the intervertebral foramen below. Type II is situated at the entrance of the intervertebral foramen and compresses the adjacent nerve root only. The extreme lateral prolapse of type III compresses the ganglion within the intervertebral foramen, but often does not produce myelographic findings. All three types, especially the extreme lateral prolapse without myelographic changes, can also be demonstrated directly by the non-enhanced CT examination. The best operative approach, which depends on the location of each prolapse, is described.

Humans↗
PubMed1983

[The reliability of computer tomography in the diagnosis of recurrent symptoms after lumbar disc operations].

In 67 patients with recurrent complaints after operations of herniated lumbar disks, the CT findings were compared with the results of the subsequent second operation. Postoperative complications as haemorrhages or inflammations appear as localised or diffuse densities within the spinal canal in the operated segment and can be diagnosed without difficulty. The differentiation between a true recurrent herniation and scar formation is difficult, mainly within the first 4 weeks after operation. Even with the administration of iv. contrast medium, the diagnostic accuracy is not higher than 70%. In addition to the enhancement effect, which is not always reliable, the shape, position and density of a suspected structure can be used as diagnostic criteria.

Adult↗
PubMed1982

[The value of CT in the diagnosis of traumatic fronto-basal CSF fistulae (author's transl)].

In 20 patients with fronto-basal CSF fistulae, radiograms, tomograms and CTs in the axial and coronal projection were taken before operation. The evaluation showed that small fractures of the cribriform lamina could be demonstrated most clearly by CT with narrow coronal sections. Although the resolution properties of CT is still inferior to that of tomography for small osseous fissures, good CT results could be achieved by the better demonstration of accompanying mucosal swelling and/or small effusions. Fractures of the walls of the frontal sinuses, on the other hand, where shown better by tomography and those of the frontal calotte by normal radiograms.

Adolescent↗
PubMed1982

[Diagnostic importance of CT examination of the lumbosacral region of patients with lumbo-sciatica (author's transl].

In 160 patients with lumbo-sciatic complaints, CT examinations of the lumbo-sacral region were carried out. In 106 of these cases, which were controlled by myelography and/or operation, the CT diagnosis was correct in 74%. In 19%, the CT findings were uncertain, and in 7% they were wrong. A reliable CT diagnosis could be made mainly in the case of a medial or medio-lateral disc herniation of a size above 0.5 cm in diameter if the patient was not operated previously, and in extremely lateral prolapses into the intervertebral foramen without myelographic changes. Small medial protrusions, specially within a narrow spinal canal, or postoperative controls often gave rise to uncertain findings. However, osseous changes as compressions of the lateral recess or the narrow spine syndrome were demonstrated usually better by CT than on routine radiograms. Nevertheless, the indication for the performance of a lumbo-sacral CT should be kept narrow and should be limited to cases with clear-cut radicular signs.

Adult↗
PubMedDate not supplied

Topography and identification of the inferior precentral sulcus in MR imaging.

Sagittal MR imaging was used to investigate cerebral sulci bordering the functionally important areas on the lateral suprasylvian surface. The aim of the study was to identify characteristic relationships of the inferior precentral sulcus to nearby sulci and gyri. MR findings in 20 healthy volunteers were compared with those in 62 intact postmortem hemispheres. MR techniques are described for the direct identification of the anterior ascending ramus of the sylvian fissure and the inferior precentral sulcus. These sulci, which border Broca's area and the primary motor area, can be reliably identified with sagittal MR. Four different types of sulcus topography were recognized. Most frequently, the inferior precentral sulcus is the sulcus posterior to the anterior ascending sylvian ramus (95% in the MR study, 87% in the anatomic study). Occasionally, an additional sulcus is interposed (5%, 10%), or an ascending ramus is absent (0%, 3%). Identification of these landmarks is important for the exact preoperative localization of cortical lesions as well as for the intraoperative interpretation of individual sulcus patterns.

Adult↗