Biomedical subjects
C A Plangger
Publications and source records attributed to C A Plangger.
Metastatic pituitary adenoma.
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Effect of torasemide on intracranial pressure, mean systemic arterial pressure, and cerebral perfusion pressure in experimental brain edema of the rat.
Torasemide, a puridine-3-sulfonylurea derivative, is a lipophilic diuretic compound. It interacts with the Na+2Cl-K+ carrier and at higher concentrations with the chloride channels. The lipophilic nature of torasemide may determine its access to glial and neuronal cells across the blood brain barrier. The present study was performed to establish whether torasemide could modify intracranial pressure and cytotoxic brain edema in functionally nephrectomized Wistar rats (150-240 g). Brain edema of the cytotoxic type was induced by infusion of 100 ml aqua bidest/kg body weight. After the end of the infusion 100 mg torasemide/kg body weight or a corresponding volume of isotonic saline were injected followed by continuous continued recording of ICP and systemic arterial pressure for at least 3 hours. Torasemide prevented the rise in intracranial pressure seen in control animals. The ICP values for the torasemide-treated animals were lower at all points. Following intravenous injection of 100 mg torasemide/kg body weight at 50, 60, 70, 90 and 120 minutes a significant decrease of intracranial pressure compared to that in controls was observed. Torasemide may be a useful adjunct in the therapy of brain edema and increased intracranial pressure.
Effect of gammahydroxybutyrate on intracranial pressure, mean systemic arterial pressure and cerebral perfusion pressure in experimentally induced brain oedema of the rat.
The effect of gammahydroxybutyrate (GHB) on ICP, systemic arterial pressure and cerebral perfusion pressure in the experimentally induced brain oedema of the rat was examined. 400 mg/kg GHB reduced significantly ICP (11.74 +/- 1.20 mm Hg; control: 16.20 +/- 8.89 mm Hg; p less than 0.01) while increasing mean systemic arterial pressure (109.89 +/- 6.35 mm Hg; control: 89.65 +/- 4.22 mm Hg; p less than 0.05) and cerebral perfusion pressure (98.11 +/- 6.79 mm Hg; control: 73.84 +/- 5.25 mm Hg; p less than 0.02). In the dose-effect curve 200 mg/kg GHB show an increase in mean systemic arterial pressure from 89.60 +/- 9.35 mm Hg to 97.60 +/- 3.48 mm Hg (p less than 0.02) and 400 mg/kg GHB to 108.00 +/- 5.20 mm Hg (p less than 0.001) mean systemic arterial pressure. Thus, the decrease in intracranial pressure is not due to a reduction in the mean systemic arterial pressure, but GHB does reduce the ICP while increasing mean systemic arterial pressure and cerebral perfusion pressure. GHB may be a useful adjunct to neurosurgical therapy in controlling elevated ICP.
Steroid-induced complete remission in a case of primary cerebral non-Hodgkin's lymphoma.
A case of a primary non-Hodgkin's lymphoma of the CNS is reported in which a complete and stable disappearance of an enhancing mass lesion on the CT scan after treatment with dexamethasone was followed by the occurrence of a high-grade malignant lymphoma in the opposite hemisphere 18 months later. The long-lasting and stable remission suggests a direct oncolytic effect of corticosteroids on lymphoma cells. Furthermore, this case illustrates the usefulness of repeated CT examinations in patients with CNS lymphoma and steroid treatment.
Rupture of a giant aneurysm of the inferior wall of the internal carotid artery after saphenous vein interposition graft to the middle cerebral artery.
A patient with a giant aneurysm of the inferior wall of internal carotid artery presented with progressive vision failure with optic nerve atrophy on the left eye. She underwent exploration of the aneurysm, which was found impossible to clip. Clamping of the common carotid artery was not tolerated there being inadequate collateral circulation. A saphenous vein graft was interposed between the occipital artery and a branch of the middle cerebral artery. The previously unruptured aneurysm bled fatally 4 hours after surgery, just before intended clipping of the aneurysm or ligation of the internal carotid artery.
[Space-occupying, traumatically-induced hemorrhage of the posterior cranial fossa].
A total of 4,408 patients were treated for head injuries from 1980 to 1986 at the University Hospital of Innsbruck in Austria. Nine of them (0.2%) showed a traumatic, space-occupying hematoma in the posterior fossa. Clinical signs are often elusive, but tentorial or foraminal herniation with apnea may suddenly arise. Heightened awareness of these lesions and closely monitoring these patients are both necessary, especially when there is a fracture over the transverse sinus or the foramen magnum. Computed tomography helps to establish the diagnosis and leads to appropriate neurosurgical treatment. The overall mortality of patients with these lesions was 22% in our patients.
Tractotomy and partial vertical nucleotomy--for treatment of special forms of trigeminal neuralgia and cancer pain of face and neck.
The therapy of face and neck pain has often been elusive. We attempted to improve the condition of these patients and tried to influence 1. pain of trigeminal neuralgia, where other forms of therapy had failed, 2. pain due to tumours in the distribution of the Vth, IXth and Xth nerve, when all other methods had proved to be unsuccessful, 3. pain due to a traumatic lesion of the Vth nerve after severe injury of the face and 4. pain in the first division of the Vth nerve after herpes zoster infection, when other forms of therapy had failed. After tractotomy the subnucleus caudalis n.V. is partially destroyed. Aim of the partial vertical nucleotomy is the interruption between the first and second neuron of the Vth nerve conveying pain and thermal sensibility, but also of the IXth and Xth nerve, which end in the subnucleus caudalis n.V. as well. Tactile and some thermal sensibility in the face is so retained, and anesthesia dolorosa or keratitis neuroparalytica avoided. Medially of and vertically to the tractotomy a 4-6 mm long incision both cranially and caudally of the tractotomy was made. For the first division of the Vth nerve the nucleotomy is performed on the lateral end of the tractotomy incision. In the patients with cancer of the face and neck a rhizotomy C 1/2 was added. 7 of the 12 patients with trigeminal neuralgia and 3 of the 6 patients with tumors of the face and neck were pain-free. The rest also showed a marked improvement.(ABSTRACT TRUNCATED AT 250 WORDS)
[Simultaneous occurrence of brain tumors and aneurysms].
Three patients with different types of intracranial tumour--glioma, meningioma and pituitary adenoma--and associated aneurysms are described. The aetiology of aneurysm formation in the presence of tumours is discussed and a review of the literature given.
Subarachnoid metastases from a prolactinoma.
A 37-year-old man developed a left frontal metastasis from a prolactin-secreting pituitary tumour, which had been operated on nine years before. The metastatic tumour was totally excised. One and a half years later he was found to have multiple left temporal and parietal subarachnoid metastases. Because treatment with bromocriptine for five months and subsequent radiation proved ineffective, the tumour nodules were removed surgically.