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Biomedical subjects

Z Czernicki

Publications and source records attributed to Z Czernicki.

At least 55 records · Page 3Linked to original sources
PubMed1989

Alteration of intracranial pressure, cerebral blood flow, autoregulation and carbondioxide-reactivity by hypotensive agents in baboons with intracranial hypertension.

Intracranial pressure (ICP) was recorded by epidural transducer and cisterna magna catheter, and regional cerebral blood flow (rCBF) using the intraarterial Xenon 133-technique were measured in baboons with normal and during increased ICP provoked by an inflatable balloon positioned subdurally. Arterial blood pressure was altered by controlled infusion of Sodium-nitroprusside (SNP), Nitroglycerine (NG) or Trimetaphan (TMP) with the aim of reducing blood pressure by about 20%. During exflated balloon SNP provoked an increase of ICP which was more prominent than with NG and TMP. During increased ICP (due to inflation of the balloon) again SNP led to a higher further increase of ICP than both NG and TMP. rCBF rose during the state of normal ICP when SNP was infused. This was not observed with infusion of NG or TMP. When ICP was increased again by inflation of the balloon all 3 substances reduced rCBF, indicating damage to the autoregulation. CO2-reactivity as measured by induced hyperventilation with reduction of arterial CO2-tension was affected by all 3 substances thus indicating impairment of vasoconstriction during increase of ICP and simultaneous decrease of blood pressure. However, this impairment of physiological vasoconstriction was more prominent with SNP than with NG and TMP. The results indicate that all 3 substances should be used with care to reduce blood pressure during surgery or under intensive care condition, particularly in patients with increased ICP.

Animals↗
PubMed1979

Treatment of experimental brain oedema following sudden decompression, surgical wound, and cold lesion with vasoprotective drugs and the proteinase inhibitor "Trasylol".

The study was performed on 81 cats with three models of experimental brain oedema: sudden decompression, surgical wound, and cold injury. During the experiments blood pressure, central venous pressure, and intracranial pressure were recorded. The blood-brain-barrier was tested with Evans blue solution. The gray and white matter tissue was sampled at the end of the experiment, and the water content and sodium and potassium concentrations were determined. The animals with the same experimental model were divided into three groups: untreated, treated with the vasoprotective agents, and treated with the protease inhibitor Trasylol. In the sudden decompression model after balloon deflation, white matter haemorrhages and oedema development were found in gray matter and basal nuclei. In animals treated with the vasoprotective drugs, haemorrhages were not observed, and oedematous changes were less pronounced. The Trasylol effect on oedema development was not significant in this model. In the surgical wound model, oedematous changes were observed after 24 hours following the lesion. Oedema occurred in the white matter, as in the animals with cold lesions. In both models--surgical wound and cold lesion--the beneficial effect of Trasylol was shown, while the effect of Aescorin was less evident. The results obtained seemed to testify to the usefulness of both Trasylol and vasoprotective drugs in the prevention and treatment of brain oedema in neurosurgical patients.

Animals↗
PubMed1979

[Use of haemodilution in the treatment of cranio-cerebral injuries (author's transl)].

By decreasing blood viscosity and vascular resistance normovolemic haemodilution increases cerebral blood flow and improves microcirculation. This eliminates the symptoms of anoxia of cerebral tissue. The extent of disturbances of the blood brain barrier is decreased. The case presented in this paper illustrates the use of the above-mentioned properties of haemodilution and concerns a patient with chronic subdural haematoma. The patient's status in the pre-operative period was very poor. Craniotomy and avacuation of the haematoma did not result in a visible improvement of the patient's state. He did not regain consciousness and even lost spontaneous respiratory function. Haemodilution /Hct 29%/ was performed using Dextran 60 and 5% human albumin in the proportions 1 : 1. As a result, spontaneous respiration was restored and there was a gradual improvement in the patient's status. 29 days later it was possible to communicate with the patient. The authors are of the opinion that haemodilution could find a much application in neurosurgery than has been the case up to now.

Brain↗
PubMed1977

Disturbances in the blood-brain barrier and cerebral blood flow after rapid brain decompression in the cat.

The effect of sudden decompression of the brain on the blood-brain barrier and cerebral blood flow was studied in cats. The decompression experiments were performed on 9 cats which had been subjected to two hours of compression with an epidural balloon and on 10 cats subjected to four hours of balloon compression. In both experimental groups one could observe haemorrhages and disturbances in the blood-brain barrier in the cortex of the previously compressed hemisphere and in the basal nuclei. The extent of these changes depended on the duration of the epidural compression. At the same time, a decrease in cerebral blood flow, mainly in the brain cortex, was observed in both experimental groups.

Animals↗
PubMedDate not supplied

Effect of stable xenon in room air on regional cerebral blood flow and electroencephalogram in normal baboons.

Measurement of regional cerebral blood flow (rCBF) was performed in 6 healthy baboons during ventilation with 35% stable xenon in artificial air. rCBF was measured with the intraarterial xenon-133 method. EEG was recorded continuously. All CBF areas of interest over one hemisphere reacted in the same way. Mean flow increased during short-term exposure to stable xenon and decreased if stable xenon inhalation was continued for at least 24 minutes. EEG showed a decrease of alpha- and beta-wave patterns a short time after the start of stable xenon inhalation without further changes over the period when rCBF finally decreased. CO2 reactivity increased in most animals, and autoregulation to mild arterial hypotension was significantly impaired with increased flow. It is concluded that 35% stable xenon in artificial air increases rCBF after short-term exposure and decreases rCBF after longer exposure. EEG changes were noted after short-term exposure. rCBF and EEG recovered rapidly after the end of stable xenon inhalation.

Administration, Inhalation↗
PubMedDate not supplied

[The application of transcranial doppler sonography in the evaluation of cerebral flow disturbances after head trauma].

Several types of cerebral blood flow disturbances, resulting from head trauma are discussed. Application of Transcranial Doppler Sonography in diagnosing of posttraumatic cerebral vasospasm and cerebral hyperaemia, increased intracranial pressure, autoregulation disturbances, and brain death is described. Clinical examples of isolated cerebral blood flow disturbances, and several types of their co-existence are given. Special attention was paid to the noninvasiveness, repetitiveness, and relative ease of use of the technique. Transcranial Doppler examination can be especially useful in diagnosis and monitoring of different cerebral blood flow disturbances, which is especially important in therapy of brain trauma patients.

Adult↗
PubMedDate not supplied

[The examination of the blood flow velocity in arterial vessel during and after encephalo-dura-arterio-synangiosis. Preliminary results].

The Japanese authors first described encephalo-duro-arterio-synangiosis, a new treatment for moya-moya disease, 17 years ago. The other authors used this method (EDAS, indirect anastomosis) in surgical treatment of patients suffered cerebral transient ischaemic attack and cerebral ischaemia. In our department this method was applied in 5 patients with cerebral ischaemia. All patients had internal carotid artery occlusion. After angiography, to localize carotid artery occlusion, acetazolamid (Diamox) test was performed. The patients with negative Diamox test were treated surgically (EDAS). The authors used the intraoperative microdoppler device to monitor blood flow velocity of the prepared vessel (temporal superficial artery) at every stage of surgery. The device was also useful in controlling the patency of encephalo-duro-arterio-synangiosis percutaneously after the surgery. The proximal and the distal part of the non-bypass anastomosis was examined in the follow up during 5-8 months before angiography.

Anastomosis, Surgical↗
PubMedDate not supplied

[Dynamics of blood flow velocity in middle cerebral arteries in dyslexic persons].

The aim of our study was to investigate the blood flow in middle cerebral arteries during the different forms of cognitive activity in dyslectic persons. Two group of subjects were tested. The first group consisted of 10 students with school difficulties, diagnosed neuropsychologically as having a particular form of dyslexia, i.e. dysgraphy or dysorthography. 6 of them were right lateralized and 4--left lateralized. The second contained 10 students without such problems. 7 of them were right lateralized and 3--left lateralized. We used four kinds of cognitive tasks, during which the blood flow velocity in MCA in left and right hemisphere was measured with the Transcranial Doppler method. The analysis of the results showed differences between the groups of blood flow velocity levels, without a difference in performance profile. The dysgraphic persons had significantly higher blood flow velocity in the right hemisphere compared to the reference group. The results suggest particularly important role of right hemisphere in dyslexic persons, which is consistent with results obtained by other authors. The analysis of lateralization showed that this factor influences significantly the blood flow velocity level--the left lateralized persons showed lower rise of blood flow velocity than the right lateralized, regardless of the kind of task and measured hemisphere.

Adolescent↗
PubMedDate not supplied

[Assessment of blood flow velocity during cognitive stimulation in persons with suspected hydrocephalus].

The aim of this work is to evaluate middle cerebral arteries (MCA) blood flow velocity changes during performance of linguistic and visuospatial cognitive tasks. Two groups were investigated: eight patients with suspected hydrocephalus without perceptible cognitive disturbances, and eight healthy persons. Blood flow velocity in left and right MCA was recorded with transcranial Doppler sonography while the examined patients were performing three different tasks. The analysis of the results showed differences between the groups concerning both increase of blood flow velocity values and performance patterns. Compared to healthy individuals less increase in blood flow velocity during performance of all tasks and no difference in haemodynamic changes between both hemispheres during task performance were observed in patients with hydrocephalus. The results obtained suggest, that the pattern of functional lateralization in brain in patients with suspected hydrocephalus is probably changed.

Adult↗
PubMedDate not supplied

[Paranoid syndrome in a patient with tumor in anterior part of corpus callosum. Case report].

The reported case was a patient with tumour situated in the region of the corpus callosum, with symptoms diagnosed initially as affective syndrome and later on as paranoid syndrome. With this diagnosis he was treated for 12 years in psychiatric out-patient clinics and hospitals with antidepressants and and neuroleptics. Brain imaging (CT and MRI) performed only after an epileptic seizure demonstrated a tumour in the anterior part of the corpus callosum with a broad oedema area. Neuropsychological examination revealed disturbances of emotional-motivation processes and defects in cognitive functions. Following surgical treatment only a slight improvement of functioning was noted. Histological diagnosis (PNET) suggested that the tumour was expanding during many years. Much earlier diagnosis with neurosurgical intervention could result in a better therapeutic effect.

Aged↗
PubMedDate not supplied

[Spread of pituitary adenomas beyond the sella].

Two cases of giant pituitary adenomas spreading extensively beyound the sella are described. In the 1st case death occurred 18 hours after the operation, in the 2nd case a good result was obtained by operation from subtemporal approach followed by 60Co radiotherapy. Control scintigraphic and angiographic examinations 11 months after treatment failed to demonstrate the signs which indicated extrasellar spread of adenoma before treatment.

Adenoma↗
PubMedDate not supplied

[Embolitic material (coils) dislocation inside a giant and cerebral aneurysm and morphological aneurysm changes after coiling. Case report].

The placement of tungsten coils into aneurysm sack in patient after SAH is a method of treatment used in many neurosurgical departments. The main indications for coiling procedures are severe neurological status (IV i V according to WFNS) and posterior circulation aneurysms. Coiling can be offered to a patient who does not agree to clipping procedure. The presented case is a patient with a giant MCA aneurysm who did not agree to clipping procedure and, therefore, was subjected to coiling. During the follow-up of 2 months; control skull X-rays and after them control angiography were performed to monitor coils arrangement in the aneurysm sack and their possible dislocation. The control angiography after 6 months showed significant enlargement of the aneurysm. The aneurysm was clipped, totally excised and subjected to histopathological examination. It was found that the material inside the aneurysm sack can change its shape due to the impact of the flowing blood (change in the coil shape, resorption and the recanalization of the clot) similarly to the natural process of aneurysm development. Morphological changes of the aneurysm appear to be also possible in spite of the thrombus formation in the aneurysm sack.

Cerebral Angiography↗
PubMedDate not supplied

[Revascularisation after encephalo-duro-arterio-synangiosis. Case report].

In surgical treatment was performed of patients after cerebral ischaemic stroke and cerebral ischaemia. The authors applied the surgical technique of indirect anastomosis (EDAS-encephalo-duro-arterio synangiosis). The Japanese authors described this method first as a treatment for moya-moya disease. The acetazolamid (Diamox) test and clinical symptoms were the main criteria to perform this surgical procedure. All patient with abnormal Diamox test were treated surgically. After 6 months control angiography was performed to visualize a new network of vessels near the main vessel (superficial temporal artery).

Cerebral Angiography↗
PubMedDate not supplied

[Application of physiological data in evaluation of the intracranial volume-pressure interaction. I. An experimental study].

In experimental studies on cats the pressure and volume loadings corresponding to the physiological situations were used. The following tests were applied: central venous pressure increase, postural changes and increase of CO2 percentage in inspired gas mixture. It was found that the central venous pressure increase test is useful in the evaluation of CSF outflow routes, the postural change test examines the intracranial compensation and the elevation of CO2 level in inspired air tests the intracranial volume reserve.

Animals↗
PubMedDate not supplied

[Relation between resorption resistance of cerebrospinal fluid and the degree of intracranial pressure].

Changes in the CSF resorption resistance in relation to the value of the intracranial pressure have been assessed in 44 cats. Changes in the intracranial pressure have been produced with fluid infusions. Between 1 to 5 infusion tests with the rate 0.012-1.8 ml/min have been performed in each animal. A relationship between CSF resorption resistance and intracranial pressure has been found. With an increase in the intracranial pressure CSF resorption resistance increased to maximum value of 34 kPa/ml per minute (255.6 mm Hg/ml per minute) at pressure 2.96 +/- 0.69 kPa (22.2 +/- 5.2 mm Hg). At the intracranial pressure about 6.7 kPa (50 mm Hg) CSF resorption resistance rapidly decreased to the value of 13.9 kPa/ml per minute (104 mm Hg/ml per minute). Later, changes have been rather slight. It is possible, that the breaking point at 6.7 kPa corresponds to the mobilisation of all ways of CSF evacuation.

Absorption↗
PubMedDate not supplied

[Use of transcranial Doppler ultrasonography for evaluation of intracranial pressure].

Transcranial Doppler (TCD) studies are very useful for the evaluation of intracranial pressure changes. The most informative for the TCD increase diagnosis are the diastolic pressure decrease and increase of two computed indices: pulsatility index (PI) and resistance index (RI). Single measurements can be misleading and therefore, monitoring of neurosurgical intensive care patients is suggested. Additional information is provided by TCD studies in cerebral blood flow autoregulation tests. The usefulness of TCD in brain death diagnosis is discussed also.

Animals↗