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Biomedical subjects

A Reinprecht

Publications and source records attributed to A Reinprecht.

22 records · Page 2Linked to original sources

Clinical evaluation of a new epidural pressure monitor.

Comparative measuring of epidural pressure using the Spiegelberg probe 1 and ventricular fluid pressure was carried out in 15 neurosurgical intensive-care patients. Deviations in both directions were established, with a trend toward overestimating ventricular pressure in epidural pressure measuring (r = 0.77). Individual pulsations, spontaneous wave courses and therapy-induced pressure changes were reflected without delays. There were no complications observed with probe implantation periods for up to 6 days. The system has been shown to be mechanically stable and easy to implant. We believe the device to be fit for trend monitoring of intracranial pressure. As with other epidural pressure monitoring systems, false assessments of ventricular pressure may lead to wrong decisions as to required therapy.

Adult↗

Atypical vertebral artery in a patient with an intra-and extraspinal cervical neurenteric cyst.

A 15 year old girl experienced Horner's syndrome on the right side, paraesthesia of the right arm and meningitis. CT and MRI showed a cystic lesion on the right side of the cervical spine at C3/C4 which descended with an extraspinal portion down to C6. Histology revealed a complex neurenteric cyst. The ipsilateral vertebral artery showed an atypical course. This abnormal artery besides a partial fusion of the vertebrae C2/C3/C4 suggest a complex malformation at the site of the cyst. Disturbed developmental relationships in this case indicate that pathological blood vessels may represent a risk factor in the surgical treatment of neurenteric cysts.

Adolescent↗

The Medos Hakim programmable valve in the treatment of pediatric hydrocephalus.

The programmable Medos Hakim valve offers the possibility of adjusting the valve's operating pressure noninvasively. We retrospectively analyzed a series of 78 children who underwent a shunting procedure using this programmable valve within the last 4 years: 46 children underwent a primary shunt placement and 32 children underwent a shunt revision with a different valve replaced by the Medos programmable valve. There were 23 complications, 9 infections, 13 mechanical complications and 1 subileus in all children. Treatment was successful with no need for further shunt revision in 29 of the children with primary shunt placements and 27 of the children with shunt revisions. In 10 cases of overdrainage this was adequately corrected by readjustment of the valve operating pressure alone. As there are no criteria for prediction of the valve operating pressure needed for any individual patient we consider this valve to be beneficial in various forms of shunt-dependent pediatric hydrocephalus.

Adolescent↗

Reversible occlusion shunt for intraventricular chemotherapy in shunt-dependent brain tumor patients.

Intraventricular chemotherapy is increasingly used in the treatment of pediatric brain tumors with leptomeningeal seeding. However, some patients are shunt dependent after surgery, probably due to adhesions in the area of surgery. To avoid drug diversion in these patients we connected the reservoir to a reversible occlusion device. Over a 2-year period a shunt value with an on-off device was inserted into the shunt assembly of eight children with various brain tumors with a poor prognosis undergoing intraventricular chemotherapy. All eight patients had tumor cells in the ventricular cerebrospinal fluid (CSF) and/or metastases by magnetic resonance imaging. The number of intraventricular drug applications ranged from 10 to 51. No shunt malfunctions or shunt-related infections occurred. The temporary closure of the shunt after drug delivery was well tolerated. In all six children with tumor cells in the ventricular CSF a negative cytology was achieved over a 3- to 8-week period.

Adolescent↗