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Biomedical subjects

A Kogler

Publications and source records attributed to A Kogler.

13 recordsLinked to original sources
PubMed2000

Postural stability using different neck positions in normal subjects and patients with neck trauma.

Subjects with neck problems, such as whiplash injuries, often complain of disturbed equilibrium and, in some instances, provocation of the neck position can elicit such problems. The importance of neck proprioceptors for maintaining balance is gaining increased interest, moreover the function or malfunction of the otoliths may disturb equilibrium in certain head positions. The aim of the study was to create a reference material for postural control and its dependence on head position in healthy subjects and to compare this with a set of patients with known neck problems and associated vertiginous problems. A total of 32 healthy subjects (16 men, 16 women, age range 21-58 years) as well as 10 patients age range 27-62 years (mean 44 years) with neck problems and associated balance problems since a whiplash injury were tested for postural control using the EquiTest dynamic posturographic model. The normal subjects were initially split into four age groups in order to estimate the effects of age on performance. The postural stability was evaluated for dependence of support surface conditions (stable or sway-referenced), visual input (eyes open or closed) and head position (neutral, left rotated, right rotated, extended backwards or flexed forward) using analysis of variance (ANOVA) with Tukey's post hoc test in case of a significant factor effect. As expected, visual cues as well as stable support surface improve postural stability (p < 0.001). Postural stability is statistically different in the head extended backwards condition compared with the other four head positions (p < 0.001 in all cases) in both patients and controls. Eliminating this test condition from the analysis, only a slight (p < 0.05) difference between head forwards and head turned left remained. This pattern of results remained if the normal subjects were only split into two age groups instead of four. Finally, the patient group exhibited significantly lower postural performance than all the groups of normal subjects (p <0.01), but none of the normal groups differed significantly from each other. It is concluded that the postural control system is significantly challenged in the head extended backwards condition in both normal subjects and patients with previous whiplash injury and persistent neck problems. The patient group differed statistically from all groups of normal subjects. This suggests that neck problems impair postural control, and that the head extended position is a more challenging task for the postural system to adapt to. Whether this is due to utricular malpositioning, central integrative functions or cervical proprioceptive afferents is not within the scope of this study to answer.

Adult↗
PubMed2000

Concomitant bihemispheric cerebral ganglioglioma and hemangioma in an 18-month-old child: case report.

This is a rare case of concomitant bihemispheric cerebral ganglioglioma and hemangioma in an 18-month-old child. There were two identical processes; a combination of ganglioglioma and hemangioma was located in the parieto-occipital region of both cerebral hemispheres. The child underwent diagnostic computed tomographic and magnetic resonance imaging examinations for seizures and right-sided facial palsy, which showed the bilateral presence of parieto-occipital, oval, well-demarcated, subcortically located processes. A biparieto-occipital craniotomy was carried out and two well-demarcated abnormalities were observed and both were removed in toto. Two years after the operation, the boy had normal psychomotor development and remained free from seizures with no therapy required. Repeat magnetic resonance imaging showed no tumor recurrence. Gangliogliomas are relatively uncommon tumors in childhood, located in the supratentorial compartment and usually associated with seizures. Histopathologic and immunohistochemical analysis of the two processes found in our patient showed them to be a ganglioglioma and a hemangioma, confirming the dysontogenetic origin of these alterations and the association between malformations and tumor growth. The combination of ganglioglioma and hemangioma, especially bilateral presentation of two such identical processes in a young child, is very rare and was not found in the recent literature.

Brain Neoplasms↗
PubMed1998

Intramedullary lipoma of dorsocervicothoracic spinal cord with intracranial extension and hydrocephalus.

An intradural, intramedullary lipoma originating within the cervicothoracic cord with significant extension into the posterior fossa is reported. The lipoma was found incidentally by CT scan at the infant's age of 2 days. Follow-up studies by CT and MRI were performed on several occasions. Because of hydrocephalus, VP shunting was performed. After shunting and shunt revisions, surgery of lipoma was performed at the age of 2 years. Posterior fossa craniectomy and laminectomy from C1 to T4 revealed a lipoma, which was maximally reduced. Six months after surgery, the child was well and showed good recovery.

Cervical Vertebrae↗
PubMed1991

Anaplastic ependymoma in children--increasing incidence?

During 1988 and 1989, 16 cases of ependymomas were diagnosed at the Department of Pathology, University Hospital "Sestre milosrdnice", Zagreb. The specimens were obtained from the Department of Neurosurgery of the same hospital. Seven tumors out of these 16 were supratentorial, four of them being diagnosed as anaplastic ependymomas. At the time of the first operation, patients with anaplastic ependymoma were aged 2 to 18 years, and there were three man and one woman. The criteria for this diagnosis were cellular pleomorphism and anaplasia, vascular hyperplasia with marked endothelial proliferation, and the most important of all, the presence of numerous mitoses. Necroses, cystic degenerations and bleeding were found in all four tumors. The aim of this study is the survey of morphology, tumor localisation and patient's age at the moment of diagnosis as relevant factors for the prognosis of these tumors. It seems significant to indicate a relatively great number of these tumors in only a two-year period in one hospital, while statistical data reported in the literature have been taken from several institutions in various towns or states for much longer period of even several decades. Hence, this study could be in favour of the idea presented in the recent literature data, that this tumor type is increasing.

Adolescent↗
PubMed1991

Diastematomyelia--case report.

An eight-month-old infant with diastematomyelia, as a very rare variety of spinal dysraphism is presented in this article. The introduction deals with a detailed description of diastematomyelia, its development, local, neurological, and orthopedic signs in affected patients, diagnostic procedures and significance of neurosurgical treatment in patients with diastematomyelia. In the particular child, immediately upon birth, a thornlike bulging was noticed in the L2-L3 region. Neurological deficit, established at the time of surgery, was due to the perinatal brain damage and corresponded to the spastic syndrome of the central origin with the right-hand side predomination, and there was no predomination in the lower extremities, which could be expected in regard to the spinal dysraphism. Plain X-ray film revealed a thornlike bulging at the L2-L3 level. Lumbar myelography showed a distinctly enlarged dural sac at the level of L2 to S1 with a well pronounced contrast medium passage defect at the L3 level. The spinal canal CT-findings revealed a bony bulging between L1 and L2, starting from the posterior arches towards the spinal canal. Besides a markedly broadened lumbar spinal canal, MR-findings also showed a well pronounced bony septum from the L2 posterior edge, and a low-lying conus medullaris with an accompanying spinal lipoma. By the neurosurgical operation bony septum and extradural lipoma were radically removed, and the spinal cord was set free from adhesions. In that way a later onset of neurological signs, due to the "tethered cord syndrome", was prevented. Six months following surgery the child's condition was still unchanged.

Female↗
PubMed1989

Cranial ultrasonography in the evaluation of macrocrania in infancy.

Cranial ultrasonography was used in the initial evaluation of 40 infants with macrocrania. Three of the infants had normal findings. The other 37 had evidence of various types of abnormality: intraventricular obstructive hydrocephalus, external hydrocephalus, arrested hydrocephalus with atrophy, or mild ventriculomegaly. All the infants were given neurological and developmental examinations at the time of presentation and were followed up for one year. Sonograms and head-circumference and intracranial pressure measurements were done at intervals, according to the initial ultrasound findings and the clinical status of the children. Neurodevelopmental outcome was related to the type of abnormality. The majority of children with external hydrocephalus were neurodevelopmentally normal at follow-up. In contrast, those with obstructive or arrested hydrocephalus had unfavourable outcomes, which may be related to the significant perinatal insult causing the hydrocephalus. CT confirmation was available for 16 of the infants.

Atrophy↗
PubMed1980

Intracerebral haematoma in an infant with haemophilia A.

A nine-weeks-old infant with haemophilia A developed an intracerebral haematoma. Intracranial operation and removal of the haematoma were performed safely under the cover of highly potent AHF cryoprecipitate. Computerized tomography of the brain is very useful for neurosurgical care of the haemophiliac patients as a noninvasive and atraumatic method of examination. The literature of intracranial operations in infants with haemophilia A under the age of one year is reviewed.

Cerebral Hemorrhage↗
PubMedDate not supplied

Ultrasound diagnosis and perinatal management of surgically correctable fetal malformations.

Among 276 fetal malformations detected during the nine year period there were 97 potentially correctable anomalies which are described in detail as are the antenatal and postnatal corrective procedures undertaken. On 35 hydrocephalic fetuses 9 were operated upon postnatally in the last 2 yr. Three months after the operation four of the babies were found to be developing normally, three moderately well while two were severely retarded. Two out six babies with cystic hygroma were successfully operated after birth and their development is now normal. Of 23 malformations of the gastro-intestinal tract (two diaphragmatic hernias, three esophageal, four duodenal and four jejunal atresias, seven omphalocele, three gastroschisis) 13 babies were successfully operated and are developing normally. In 8 out of 10 antenatally detected cases of obstructive uropathy antenatal intervention was undertaken. In one case a shunt catheter was inserted for the last three weeks before delivery. Puncture and urine evacuation was performed in seven of the babies. Five were live born and surgical correction was successfully undertaken after birth, while two died (one multiple malformations and the other respiratory distress syndrome). After excluding multiple and chromosomal anomalies the best results are obtained in the correction of gastro-intestinal tract atresia (9 of 11) and obstructive uropathy (5 of 7), where once a passage has been established the baby develops normally. Interventions such as shunts in hydrocephalic babies are always a matter for discussion in relation to the final outcome, but when there is no other choice, this too is a way of endeavouring to help such a baby. Early antenatal diagnosis is therefore extremely important when interruption of pregnancy is still feasible. In cases of malformations detected at a later gestational age early diagnosis facilitates the assessment of the development of the affected organ, possible timely antenatal correction, team consultation regarding the time and mode of delivery and preparations for postnatal correction. Such an antenatal approach makes it possible to significantly influence the perinatal outcome.

Abdominal Muscles↗
PubMedDate not supplied

[Neurosurgical treatment of children with spina bifida associated with congenital spinal lipoma in the lumbosacral region].

This paper presents twelve neurosurgically treated children with spina bifida associated with congenital spinal lumbosacral lipoma over a 3-year period. The introduction deals with various types of lipoma, their development, clinical presentation, local findings in children with spinal lipoma, as well as with the significance of neurosurgical treatment. The age span of children with occult spina bifida and spinal lumbosacral lipoma was from 3 months to 2 years, and there were seven girls and five boys. In all the twelve children, a smaller or bigger fatty mass in the lumbosacral area was noticed immediately after birth, gradually increasing in size. Neurologic examination revealed weakness of lower extremities, with somewhat atonic sphincters, in only two of the children. Spinal dysraphism was demonstrated by plain roentgenograms in all the twelve children, while CT-scans, CT-myelography and recently MR-scans, confirmed the diagnosis of spinal lipoma. In all the twelve children the spinal lipoma and the adherences between the lipoma and the low-lying conus or an enlarged filum terminale were removed by the neurosurgical excision. Follow-up of children 6 and more months following the surgery showed improvement of their condition. Spina bifida associated with congenital spinal lumbosacral lipoma is a condition that although benign in histology, can have devastating effects if not surgically corrected early. Children who are asymptomatic at the time of repair will tend to remain asymptomatic. Those who are not repaired early will develop and show subsequent deterioration as time progresses.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗