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Biomedical subjects

W J Bock

Publications and source records attributed to W J Bock.

114 records · Page 7Linked to original sources
PubMedDate not supplied

Cerebellar mutism syndrome.

Since 1980, a growing number of pediatric patients with mutism following posterior fossa surgery have been recognized. This syndrome typically affects children and in rare cases young adults who become mute one or two days after tumor operation but do not show disturbances of consciousness or language comprehension. The disorder persists for 1 to 4 months. The pathogenesis is still unknown. Of 21 children who underwent surgery for large posterior fossa tumors between 1991 and 1995, 6 developed cerebellar mutism. Histologically the tumors were classified as astrocytoma WHO grade I, astrocytoma WHO grade II and ependymoma WHO grade III in one case and medulloblastoma WHO grade IV in three cases. Besides the clinical course, intraoperative findings and CT or MRI data are evaluated and discussed considering possible etiological hypotheses. Our own experience and also literature reviews suggest that the lesion of the cerebellar hemispheres might be the most important one of multiple factors causing cerebellar mutism. Generally the syndrome is transient. The diagnosis should not delay adjuvant therapy in patients with a malignancy.

Adolescent↗
PubMedDate not supplied

Rhinological findings following transantrosphenoidal surgery of the pituitary gland.

Fifty patients with pituitary gland tumours on whom we operated via the transantrosphenoidal route, were rhinologically followed up with a view to revealing any conceivable functional impairments incurred by this method. Our investigations included rhinoscopy, endoscopy of the nasal and paranasal cavities and of the epipharynx, X-ray controls, and probes of the nn. olfactorius and trigeminus. Apart from the technical advantages of transantrosphenoidal pituitary gland surgery, the results also confirmed its benefit to functional performance.

Adenoma↗
PubMedDate not supplied

Motor evoked potentials in patients with spinal disorders: upper and lower motor neurone affection.

Motor evoked potentials (MEP) following magnetoelectric stimulation allow for detection and quantification of a lesion of the central and peripheral motor pathways. MEP latency is a very sensitive parameter, irrespective whether the lesion affects the upper motor neurone, e.g. in cervical myelopathy, or the lower motor neurone e.g. in cervical or lumbar radiculopathy. However, an increase of MEP latency alone does not allow for a distinction of either upper motor neurone or lower motor neurone affection. We have therefore scrutinized MEP latency and MEP waveform (amplitude, duration, and number of phases) in normal subjects, as well as in patients with cervical myelopathy (upper motor neurone affection: UMNA) and in patients with radiculopathies (lower motor neurone affection, LMNA). The increase of central motor latency compared to normal values was significantly higher in UMNA than in LMNA. MEP following transcranial magnetoelectric stimulation were split up and their duration in relation to M-wave duration was significantly increased in patients with UMNA, yet normal in patients with LMNA. MEP amplitude in relation to M-wave amplitude was significantly decreased in patients with UMNA, yet normal in patients with LMNA. We conclude that cervical myelopathy and cervical or lumbar radiculopathies lead to changes of MEP waveform, which are specific for either upper or LMNA. The analysis of amplitude, duration, and number of phases of MEP following transcranial stimulation increases the diagnostic value of MEP in disorders of the spine affecting the central or proximal peripheral motor pathways.

Adolescent↗