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C Plets

Publications and source records attributed to C Plets.

At least 55 records · Page 3Linked to original sources
PubMed1993

Controversies in the management of spontaneous cerebellar haemorrhage. A consecutive series of 49 cases and review of the literature.

We have reviewed our experience with a series of 49 consecutive patients with spontaneous cerebellar haematoma, treated according to a standardized management protocol. Seventeen patients were managed conservatively, 30 underwent ventricular drainage, and in six patients the haematoma was evacuated. The indications for the different modes of treatment are discussed. The most significant prognostic factors determining the outcome at one month were the grade of quadrigeminal cistern obliteration on the initial CT scan and the Glasgow Coma Scale on admission. Patients with normal cisterns had a good outcome, and only needed (temporary) ventricular drainage in case of hydrocephalus. Patients with totally obliterated cisterns had a bad outcome irrespective of treatment. In the patients with compressed cisterns, it is suggested that evacuation of the haematoma might improve outcome; treatment of hydrocephalus alone is insufficient in many cases in this group.

Adolescent↗
PubMed1993

Nonaneurysmal subarachnoid hemorrhage: prevalence of perimesencephalic hemorrhage in a consecutive series.

The perimesencephalic type of nonaneurysmal subarachnoid hemorrhage (SAH) is a recently described clinical and radiological entity, with a good outcome. We carried out a retrospective analysis of 294 patients with subarachnoid hemorrhage, of whom 62 had a negative four-vessel angiography. We identified 20 cases with the typical computed tomographic (CT) pattern of perimesencephalic hemorrhage, in whom the prognosis was invariably good. However, five cases of aneurysmal subarachnoid hemorrhage had a more or less similar CT appearance: the diagnosis cannot be made on the CT image only and angiography remains mandatory. The use of bed rest, antifibrinolytics, and calcium antagonists is discussed.

Female↗
PubMed1993

Cerebellar hemorrhage complicating supratentorial craniotomy: report of two cases.

One of the rare complications of supratentorial craniotomy is the occurrence of a hematoma in the cerebellum. Only seven previous cases have been published, and these have been ascribed to disturbed blood coagulation or decreased intracranial pressure. We present two similar patients, in whom, however, the pathogenetic role of these factors seems improbable.

Cerebellar Diseases↗
PubMed1993

Variable effects of explosive or gradual increase of intracranial pressure on myocardial structure and function.

BACKGROUND: Studies done in potential donors for heart transplantation and in experimental animals have suggested that brain death can have major histopathological and functional effects on the myocardium. METHODS AND RESULTS: We developed experimental models of brain death using dogs to study the hemodynamic and catecholamine changes, the extent of myocardial structural damage, and the recovery potential of donor hearts obtained from brain-dead donors. Brain death was caused by increasing the intracranial pressure (ICP) suddenly or gradually by injecting saline in an epidural Foley catheter. In a first series of experiments, dogs given a sudden rise in ICP (n = 5) showed a hyperdynamic response and a 1,000-fold increase in the level of epinephrine after brain death. Histology revealed 93 +/- 2% of the myocardium to be severely ischemic. Dogs given a gradual rise in ICP (n = 6) showed a lesser hyperdynamic response, almost 200-fold increase in the level of epinephrine after brain death, and mild ischemic damage to the myocardium (23 +/- 1%). In a second series, hearts obtained from brain-dead and non-brain-dead donors were transplanted in recipients, and the weaning and recovery potential were studied. All four recipients with hearts from non-brain-dead donors were weaned with good functional recovery. Also, all four recipients with hearts from brain-dead dogs given a gradual rise in ICP were weaned with only moderate functional recovery. However, only two of four recipients with hearts from donors given a sudden rise in ICP were weaned and showed poor functional recovery. CONCLUSIONS: Our results indicate that a sudden rise in ICP can cause irreversible myocardial damage.

Animals↗
PubMed1993

Catecholamine response to a gradual increase of intracranial pressure.

To determine the catecholamine response to progressive intracranial hypertension, intracranial pressure (ICP) was raised gradually by continuous expansion of an epidural balloon in seven dogs. Hemodynamic parameters, ICP, and cerebral perfusion pressure (CPP) were monitored continuously and serum catecholamine levels began to rise when CPP was in the low-positive range (20 to 30 mm Hg), reaching a peak just after brain death (CPP < or = o mm Hg). There was no correlation between ICP and the catecholamine peak. Compared to control values, the mean increase was 286-fold for epinephrine and 78-fold for norepinephrine. Temporally, the catecholamine peak corresponded well with the observed hemodynamic changes. These results suggest that ischemia in certain parts of the brain stem is responsible for the hemodynamic changes observed in intracranial hypertension (such as the Cushing response), and they show that catecholamines play an important role in these hemodynamic changes.

Animals↗
PubMed1993

Embolization of arteriovenous malformations of the brain: preliminary experience.

Transcatheter embolization was performed in 8 young patients (mean age 24.5 years) with intracerebral arteriovenous malformations. In total 12 arteries were embolized in 10 sessions. Clinical complaints of the patients included epilepsy in 4, sudden coma in 3 and severe sudden neurological deficit in 1. Intracerebral hemorrhage was documented in 4 patients and subarachnoid hemorrhage in 1. In all patients, prior to embolization a superselective Wada-test was performed under wake-up anesthesia. Embolization was performed with a mixture of acrylic glue and lipiodol. In one patient a detachable balloon was added. In 6 patients embolization of all the feeding arteries was possible, with total obliteration of the arteriovenous malformations in 4 and subtotal embolization (> 90%) in 2. In 2 patients reduction of the size of the arteriovenous malformation by one third was followed by total surgical removal of the lesion. In 1 patient reflux of the embolization material in the anterior choroidal artery caused severe neurological deficit with good clinical recuperation.

Adolescent↗
PubMed1993

Intracerebral primitive neuro-ectodermal tumor (PNET).

A case of intracerebral primitive neuro-ectodermal tumor (PNET) is presented. PNETs are rare, undifferentiated neoplasms occurring primarily in children and young adults. These tumors exhibit a highly malignant behaviour with a tendency to disseminate along the cerebrospinal fluid (CSF) pathways. Preoperative diagnosis is difficult, owing to the non-specific CT and MR appearances and to the rarity of this tumor. Our patient was 33 years old, which is uncommon. CT findings initially suggested an intracerebral hematoma. Later on, CT and MR findings were specific for a brain tumor and showed a solid, non-calcified invasive mass, with poor perilesional edema.

Adult↗
PubMed1992

Isodense subdural haematomas on CT:MRI findings.

MRI findings are described in two patients with subdural haematomas isodense on CT. In one patient, admitted 6 weeks after trauma, a chronic subdural haematoma showed extreme hypointensity on T2-weighted images, suggesting acute trauma, and therefore acute rebleeding. In the second patient with severe anaemia, an acute subdural haematoma was hyperintense on T2-weighted images, suggesting chronic trauma; this may be explained by the low haematocrit and a possible mixture of blood with cerebrospinal fluid. The MRI features of subdural haematomas and hygromas have to be kept in mind, in order not to misjudge the age of the haematoma.

Female↗
PubMed1992

Intraspinal juxta-facet cysts: a case of bilateral ganglion cysts.

Juxta-facet cysts are relatively uncommon intraspinal lesions, causing radiculopathy, neurogenic claudication or myelopathy. To the best of our knowledge, only 4 cases of bilateral synovial or ganglioncysts were described. We report the 5th case of bilateral ganglioncysts of the lumbar spine. Generally, juxta-facet cysts should be differentiated from other intraspinal lesions, such as herniated discs, meningiomas and neurinomas. Correct preoperative diagnosis is necessary for adequate treatment, namely the (microscopic) resection of the cyst. After adequate treatment, complete recovery may be expected.

Aged↗
PubMed1992

The radiological differentiation of acoustic neurinoma and meningioma occurring together in the cerebellopontine angle.

A patient with right hearing loss, in whom computed tomographic scanning demonstrated a mass in the right cerebellopontine angle with widening of and extension into the internal auditory canal, but with important posterior extension and broad implantation on the surface of the petrous bone, is reported. On both T2-weighted and gadolinium-enhanced T1-weighted magnetic resonance images, there were clearly two separate tumoral lesions: an acoustic neurinoma extending into the internal auditory canal and a meningioma with broad implantation on the petrous apex. These findings were confirmed at surgery.

Cerebellar Neoplasms↗
PubMed1992

MR features of intracranial hemangioblastomas.

The contribution of MR in 10 patients with surgically proven intracranial hemangioblastomas was retrospectively evaluated and correlated with the computed tomographic findings. Angiography was obtained in eight cases. Multiple lesions were shown in only two patients, but none proved to have von Hippel-Lindau disease. In six patients the tumor typically appeared as a cystic lesion with an intensely enhancing mural nodule at the pial surface of the cyst; three patients presented with a solid lesion with a central cyst and one with a solid lesion only. Thirteen tumors were located in the posterior fossa, with one in the brain stem extending towards the spinal cord. A supratentorial localization was found in two patients. Abnormal serpiginous vessels supplying or draining the mural nodule or solid lesion were not visualized on contrast-enhanced computed tomography, but were easily identified as flow voids on MR in five patients. Calcification or hemorrhage were not seen in the entire series. Because of the multiplanar imaging capability and the lack of streak artifacts from the petrous bone, MR provides better localization than CT. MR is more accurate in predicting the number, extension and vascularity of hemangioblastomas, and provides a sound basis for further diagnostic and therapeutic procedures.

Adult↗
PubMed1992

Synovial cyst at the C1-C2 junction.

Intraspinal synovial or ganglion cysts of the cervical spine are rare. We present the third reported case of a degenerative articular cyst of the upper cervical spine, involving the quadrate ligament of the odontoid process. Magnetic resonance examination reveals typical images. A new, more general terminology is proposed.

Aged↗
PubMed1991

Extradural epidermoid tumor of the frontal bone.

The radiologic findings in a case of an extradural diploic epidermoid tumor (ET) of the frontal bone, examined with plain X rays, CT and MRI, are reported. A head injury with traumatic inclusion of epidermis could have been the origin of the tumor. This report stresses the importance of the plain skull X ray in the diagnosis of extradural ET.

Adult↗
PubMed1991

CT and MRI of ruptured intracranial dermoids.

Two patients with ruptured intracranial dermoids, examined with both CT and MRI are reported. Clinical presentation was transient cerebral ischemia in one patient and acute meningeal signs in the other. CT scan showed typical fat density of the tumor and the subarachnoid space. On MRI both the tumor and the subarachnoid fat, were strongly hyperintense on T1-weighted images.

Adolescent↗
PubMed1991

Craniofacial resection for anterior skull base tumours.

This study presents a series of 10 patients with anterior skull base tumours, treated by a team of neurosurgeons and head- and neck surgeons. The series included 7 malignant tumours of the nose and paranasal sinuses and 1 retinoblastoma, all with intracranial extension through the lamina cribrosa. There were also 2 patients with an anterior base meningioma, growing into the ethmoid sinus and the nasal cavity. 8 tumours were resected by a combined bifrontal craniotomy and uni- or bilateral rhinotomy. In 2 cases a bifrontal craniotomy alone without facial incision sufficed. The skull base was closed with a pediculated pericranial flap and a split-thickness free skin graft underneath. There were no postoperative problems of wound infection, CSF-leakage or meningitis. Recurrent tumour growth or systemic metastasis occurred in 5 out of 7 patients with malignant tumours, 6 months to 2 years postoperatively. The related literature and especially questions of operative indications and technique, including different possibilities of closure and reconstruction of the skull base, are discussed.

Adenocarcinoma↗
PubMed1990

Hemangioblastoma of the lateral ventricle.

A case of hemangioblastoma of the right lateral ventricle is presented. Only five other cases of intraventricular hemangioblastoma have been reported. The literature on supratentorial intraventricular hemangioblastoma is reviewed.

Adult↗
PubMed1990

Therapeutic approach of posterior fossa tumours in adults. A retrospective study.

The authors present a review of their experience with posterior fossa tumours in adults during a period of 20 years. Symptoms, physical findings, tumour histology, operative treatment and results are reviewed in 109 cases. The value of preoperative normalization of intracranial pressure by insertion of a ventriculo-subcutaneous drainage is discussed.

Adolescent↗