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Biomedical subjects

A Witzmann

Publications and source records attributed to A Witzmann.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Brain abscess. Prognostic factors].

Thirty-eight cases of cerebral abscess were analysed retrospectively for any factors that might influence outcome. Using the "Glasgow outcome score", age, history, level of consciousness, as well as various computed tomography findings (cisternal swelling, compression of the ventricular system, degree of oedema and size of abscess) were considered for their prognostic value. It was found that age over 40 years and clouded consciousness exerted a statistically significant unfavourable effect (P less than 0.05). Outcome was also unfavourable in half the patients with multiple abscesses, but the number of cases (six) was too small to be statistically significant. All other variables had no statistically significant influence on prognosis.

Adolescent↗
PubMed1988

[Chronic subdural hematoma in aged patients. Diagnostic problems].

The history, clinical features, laboratory tests and admission circumstances were analysed retrospectively in 14 patients, aged 60 to 87 years, who were found to have a chronic subdural haematoma. Typical clinical features consisted of dominant psychiatric disorders, slow progression and frequently only traces of neurological signs. In only four patients was headache the initial symptom. Delay in diagnosis and treatment worsened the prognosis. Several factors account for the nonspecific signs and symptoms: diffuse cerebral atrophy, dementia of a degenerative or vascular nature, and cerebral decompensation. Computed tomography immediately after a trauma may be negative.

Accidental Falls↗
PubMed1988

Diagnostic value of different electrophysiologic tests in cervical disk prolapse.

We evaluated 24 patients with radiologically verified cervical disk prolapse. EMG abnormalities appeared in 67% of cases studied; dermatomal somatosensory evoked potentials revealed 85% abnormal findings on the affected side, but also revealed abnormalities in adjacent segments. In 38%, F responses were abnormal. We found electrodiagnostic abnormalities at levels without a disk prolapse, probably due to degenerative spondylopathic changes and beginning consecutive vascular compromise.

Adult↗
PubMed1988

[Changes in somatosensory evoked potentials in response to the combined use of extra- and intracerebral pressure: an experimental study].

The impact of the combined application of extra- and intracerebral pressure on somatosensory evoked potentials (SEP) was investigated on 24 rats. The pressure upon the somatosensory cortex was applied via a 5 x 5 mm glass stamp which included a ceramic-diaphragmal electrode for recording the SEP, EEG and DC-potentials. The intracerebral pressure was evoked by a Fogarty-balloon catheter. The balloon catheter was inserted into the ipsilateral sensorimotor white matter. Slow increase of the balloon volume without additional epicortical pressure caused SEP changes at about 0.08 ml balloon volume. The application of 50 g pressure onto the cortex prior to balloon inflation led to SEP changes at 0.02 ml balloon volume, which showed a steep increase with further expanding balloon volume. In view of possible brain lesions due to brain retraction in intracerebral mass removal procedures the effects of intermittently and continuously applied epicortical pressure in addition to a given intracerebral mass (0.05 ml) were studied. In intermittent as well as in continuous pressure application the effects of both small (P = 25 g) and severe (P = 100 g) pressure were compared with. Even small pressure lasting for 60 minutes continuously caused SEP changes, which recovered only incompletely. In cases of intermittent application of small pressure the SEP pattern recovered completely. Severe epicortical pressure was followed by SEP changes, which did not recover neither in intermittent nor in continuous application. Irreversible disturbance of the microcirculation was assumed to be the reason.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

[Value of early acoustic and somatosensory evoked potentials in monitoring and prognostic assessment of coma in barbiturate therapy--comparison with clinical aspects and EEG].

25 comatose patients suffering from severe cerebral lesions of different etiology were examined during barbiturate-therapy by Glasgow-Pittsburg-Coma-Scoring-System (GPCS), EEG, somatosensory and brainstem acoustic evoked potentials. The findings were correlated in view of prognostic prediction and importance for monitoring. A modified form of the Glasgow-Outcome-Score (GOS; independent-survival, dependent-survival, dead) was used for evaluating the outcome. In case of an initial GPCS less than 10 points none of the patients survived, in case of GPCS greater than 10 points 11 out of 19 patients survived. The latter relation of survival was also found in patients with improving or impairing scores during the observation period. In case of initial burst-suppression pattern in the EEG 7 out of 11 patients survived, in case of diffuse abnormalities with or with-out additional focal signs - 4 out of 10 patients survived, but in the latter there was none with an outcome of independent survival. All patients with an isoelectric EEG died. In case of bilateral recording of scalp- SEP 7 out of 11 patients survived, in case of unilateral loss of scalp-EP 4 out of 8 patients survived, but in the latter cases none with an outcome of independence. All patients with initial bilateral failure of scalp-SSEP or loss during the observation period died. In case of bilateral registrable BAEP (wave I to V) 11 out of 17 patients survived. All patients with initial uni- or bilateral failure of those potentials or loss during the observation period died.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Carpal tunnel syndrome: neurographical parameters in different stages of median nerve compression.

In a series of 47 cases and 55 hands operated upon for carpal tunnel syndrome, the pre-operative electrodiagnostic findings have been compared retrospectively with the morphological findings within the carpal tunnel during operation. As a main result there was no significant correlation between the degree of electrophysiological changes and the degree of median nerve compression. Only the lack of any motor or sensory response seems to indicate a more severe median nerve compression. In about 20% of cases with operatively proven marked median nerve compression, both distal motor latency and motor nerve conduction velocity were well within normal limits and would not have led to the diagnosis of a carpal tunnel syndrome in these cases. The diagnosis, therefore, cannot be made on the basis of electrodiagnostic pathological values only of distal motor latency and motor nerve conduction velocity, but has to take into account as well the sensory nerve conduction velocity as well as the clinical picture and neurological findings.

Adult↗
PubMed1986

Somatosensory evoked potentials (SSEPs) in various groups of cerebro-vascular ischaemic disease.

Fifty-eight patients suffering from cerebrovascular ischaemic diseases were examined by means of somatosensory evoked potentials (SSEPs). The early components during the first 50 msec were evaluated (N13, P15, N20, P28, CCT = N13-N20). The patients were divided into 4 groups according to the affected vascular region and the reversibility of the symptoms. Reversible ischaemic attacks in the vertebro-basilar artery region: 16 patients. Reversible ischaemic attacks in the internal carotid artery region: 14 patients. Non-reversible ischaemic deficits in the internal carotid artery region: 16 patients. Diffuse vascular encephalopathy: 12 patients. The two groups suffering from reversible ischaemic attacks did not show any significant SSEP differences, either when the right and left sides were compared, or when the groups were compared to a control group. Patients with non-reversible ischaemic deficits of the carotid artery system showed a significant difference of the N20-P28 amplitude compared to controls; it was increased on the non-affected side. The latencies of N20 and CCT showed a significant increase on the affected side; P15 components revealed significant delays on both sides. In patients with diffuse vascular encephalopathy significant delays of N13 and P15 were found on both sides, whereas the CCT was unaffected on both sides. The results are discussed in view of the topologic aspects and reversibility of symptoms.

Cerebrovascular Disorders↗
PubMed1986

[Partial vertical nucleotomy as a modification of tractotomy of the trigeminal nerve].

The authors report on partial vertical nucleotomy, a modification of tractotomy of the quintothalamic tract. In 1979 eight patients underwent this procedure. Three of them showed a recurrence of pain from genuine trigeminal neuralgia. Three patients had symptomatic trigeminal neuralgia, one patient atypical neuralgia of the face without organic cause, whereas in one case the neuralgia occurred subsequent to a herpes zoster. At the time of examination all patients were free from pain.

Facial Pain↗
PubMed1986

[Intraoperative somatosensory evoked potentials (SSEP) in surgery of cerebral aneurysms: topographical information].

Out of 114 patients who were operated because of cerebral aneurysms, 16 patients were monitored by means of Somatosensory Evoked Potential (SSEP) during the operation. In 9 of these, successful monitoring was possible during the whole duration of the surgical procedure. In the remaining seven, monitoring was impossible over a long period so that these patients were excluded from the present study. Monitoring of the cerebral functions by means of SSEP provides help in aneurysm surgery as follows: Objective evaluation of the function of the somatosensory system. The induced arterial hypotension--usually done in our department--implies danger for the brain, particularly, if rupture of the aneurysm occurs at the same time. In this case, Somatosensory Evoked Potentials provide the possibility to detect lesions of somatosensory neurons at different levels. This makes prognostic conclusions possible. Pathological changes of some SSEP components during temporary occlusion of arteries of the Circle of Willis indicate developing lesions of brain structures. Intraoperative SSEP data were correlated with the postoperative course in all 9 patients. Prognostic conclusions derived from these data are discussed.

Adult↗
PubMed1985

[Results of surgical treatment of common peripheral nerve lesions of the upper extremities].

The results of operative treatment and clinical as well as electrodiagnostic findings are discussed in 68 cases. In about one half of our cases a carpal tunnel syndrome was found with excellent outcome of the operation in 93,6%, with fairly good outcome in the rest of the cases. In 14 of the patients studied a sulcus nervi ulnaris syndrome was seen, 9 of them showing excellent improvement after operative neurolysis was performed. Motor function improved in 8 out of 11 traumatic nerve dissections; Restitutio ad integrum was seen in incomplete lesions of the brachial plexus only, useful recovery of motor and sensory functions in 7 out of 10 patients with total plexus lesions. Regarding these good results of operative treatment of mechanical lesions of the peripheral nerves an exact clinical and neurophysiological examination has to be done for diagnosing and localizing those peripheral nerve affections.

Adult↗
PubMed1985

[Ventriculo-cardiac shunt in an adult with a fatal complication: diagnostic and therapeutic aspects. Case report].

A 29-year-old patient with a Pudenz-Heyer-shunt was assigned to examination because of exercise-induced dyspnea after 10 years of uncomplicated follow-up. Echocardiography established the diagnosis of advanced cor pulmonale, the cause being multiple pulmonary embolism produced by thrombotic layers on the shunt-tube. During anticoagulant therapy right heart decompensation with fatal outcome occurred.

Adult↗
PubMed1985

[Somatosensory evoked potentials in comatose patients: comparison with clinical findings, EEG and prognosis].

21 comatose patients were examined by somatosensory evoked potentials (SSEP). The findings were correlated with the stage of brainstem herniation, the EEG and the outcome. We evaluated the early components of the SSEP (N10, N13, N14, P15, N20) in view of presence, latency and interpeak-latency of the potentials. In most cases the percentage of abnormal SSEP increased from caudal to rostral registration sites, but the potential P15 and N20 were equally abnormal. The progression of herniation correlated with increasing abnormality of the potentials. SSEP over the scalp (P15, N20) could not be registered in patients without any EEG-activity (isoelectric). Mean values of latencies and the interpeak-latencies were significantly prolonged in all cases with fatal outcome. Our findings suggest SSEP as a useful tool in the evaluation of brain-dysfunction in comatose patients.

Adult↗
PubMed1985

[Temporary bypass in carotid surgery; peroperative study of various metabolic parameters and the EEG].

Out of a whole of patients of nearly 1000 reconstructive operations of the extracranial carotid artery, which were carried out by a systematic application of the intraluminal shunt, 32 selected patients with extracranial stenosis of the internal carotid artery were examined intraoperatively as to the following parameters of the internal carotid artery and the internal jugular vein: pH, pCO2, pO2, B.E. and the lactate were determined as well. Statistic analysis shows a significant increase of the arteriovenous difference of the lactate from the first to the second and from the first to the third sample.

Brain↗
PubMed1984

[Differential diagnosis and surgical indications in lumbar intervertebral disk recurrence].

This retrospective study concerns 48 patients who underwent reoperation some time after lumbar disc surgery because of persistent or recurring leg pain. During the same period (January 1980 to October 1982) 821 primary lumbar discectomies were done. Surgical findings at reoperation of 48 patients: 30 patients (3%) had a recurrent disc herniation at the previous site, 9 patients (1%) had disc herniations at a new site only, and 9 patients (1%) had only considerable epidural scar formation. The preoperative differentiation between symptoms related to recurrent disc herniation and those related to epidural scar formation is difficult, because in this situation myelography can not be relied upon. In our series of 48 patients, myelography showed in 27% of the cases false positive or false negative results. The clinical signs and symptoms are therefore of paramount importance.

Adult↗
PubMed1984

[Neuropsychologic aspects of spastic torticollis].

On behalf of the limited number of patients, statistical analysis and correlations had not been possible. It was evident however that two groups of patients can be differentiated: One with depressive-neurotic mechanisms and the other without signs of any neurotic-depressive state. It can be concluded that patients with depressive-neurotic signs give poor results after surgical procedures, whereas the other group gives satisfactory surgical results.

Adult↗
PubMed1984

[Somatosensory evoked potential in general anesthesia].

Somatosensory evoked potentials (SSEP) were investigated under general anaesthesia in 12 patients with no history of previous cerebral disease. With the commonly-used stimulation of the median nerve on the wrist, conduction from the homolateral Erb's point, and contralateral conduction from the mastoid and sensory cortical area, SSEP were registered during the first 100 msec. after the stimulation. Latency period, shape and amplitude of the spinal and subcortical components and early cortical potentials (N 20, P 28) show no change, whereas the consecutive negative and positive cortical SSEP show a definite change in shape and latency period. No change was registered in somatosensory impulse conduction and early cortical response under general anaesthesia and these can, therefore, be used during neurosurgery as a parameter for the control of cortical and subcortical functioning.

Adult↗
PubMed1983

[Peroperative evoked potentials in neurosurgery].

The application of somatosensory evoked potentials in different fields of neurosurgical procedures are presented. SSEP are used for the intra-operative control in aneurysm surgery, during a.v. malformation surgery specially in the posterior fossa and in the operative treatment of large acoustic neurinomas. Finally the authors describe their technic of anterior spinal cord stimulation in transthoracic approach in spinal cord traumatic lesions. In this patients proven intra-operative neuronal continuity allows good prognosis of functional recovery.

Brain↗