[Effect of inhalatory anaesthetics and neuroleptoanalgesia on the pressure of the cerebrospinal fluid under conditions of normo- and hyperventilation].
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Biomedical subjects
Publications and source records attributed to A Szpiro-Zurkowska.
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For activation of electrocorticographic records the authors administered intravenously thiopental or Brietal to 86 patients undergoing operations for various types of focal epilepsy. Thiopental was administered either in intravenous drip infusion as 0.2% solution, or in a single injection of 2.5% solution. Brietal was injected as 1% solution intravenously. Thiopental activated electrocorticographic tracings in 56.3% and Brietal in 84% of the patients. In the conclusions the authors stress that both these agents may be used for activation of pathological discharges in ECoG in patients with epilepsy operated upon under general anaesthesia. Brietal seems to be better and it may be administered many times.
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Problem of surgical treatment in the elderly is still discussed in the literature. This group of patients needs especially clear criteria of qualification for extensive intracranial procedures. The authors present their own experience with 35 patients over 70 years old with intracranial tumours and intracranial aneurysms treated in Department of Neurosurgery, Warsaw Medical School between 1992-1993. Among 11 patients treated conservatively, only 3 patients were in poor physical state with functional limitation which was a contraindication for surgery. Postoperative mortality was 4.2%. On the basis of our experience we think that patients over 70 years can be safely operated on intracranial lesions and the age is not a contraindication for neurosurgical procedures.
The aviator's antigravity suit (G-suit) was used for 40 operations on neurosurgical patients operated on in sitting position. The G-suit was filled with air to 0.2 atmosphere (20 kPa) pressure in 26 cases, and 0.3 atm. (30 kPa) in 14 cases. In all cases G-suit filling was followed by central venous pressure rise and mean arterial pressure rise. Venous air embolism was found in 5 (12.5%) patients. No other complications connected with the use of G-suit were observed.
Non-traumatic rhinorrhoea of CSF occurs much less frequently than traumatic ones. The most frequent causes of this rhinorrhoea are congenital abnormalities of the cranial bass. Non-traumatic rhinorrhoea with normal cerebrospinal fluid pressure and those with raised CSF pressure are known. In the latter rhinorrhoea is one of the signs of a disease causing CSF pressure rise. In view of the rare occurrence of nontraumatic rhinorrhoea 6 cases are reported which were treated in the years 1986-1993 in the Neurosurgery Department, Medical Academy in Warsaw.