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Biomedical subjects

C Probst

Publications and source records attributed to C Probst.

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

Multiple frontobasal meningoencephaloceles in neurofibromatosis.

A patient is reported who has multiple osseomeningeal defects and bilateral frontobasal encephaloceles in the context of a neurofibromatosis. After frontobasal revision with plastic closure of a cerebrospinal fluid fistula, the rhinoliquorrhea cleared, but there was an aggravation of a preexisting internal hydrocephalus with signs of raised intracranial pressure. The conditions were stabilized after various shunt operations. Additional diagnoses included a cyst (possibly a colloid cyst) in the anterior third ventricle and partial aplasia of the anterior trabecula. The particular problems in this case in relation to the spinal meningoceles already known in neurofibromatosis and spheno-orbital encephaloceles are discussed.

Adult↗
PubMed1989

[Traumatic dislocations/dislocation fractures of the cervical spine. Neurosurgical experiences in 42 surgical patients].

Neurosurgical results in 42 patients operated on for cervical spine dislocations or fracture-dislocations are described. The study shows that repositioning with the Crutchfield extension is almost always successful. Imbricated fractures must occasionally be repositioned surgically (2 cases). A strikingly large proportion of patients (50%) in whom decompression was carried out ventrally were found to be suffering from traumatic disc hernia in the lower cervical spine. This was often accompanied by laceration of the posterior longitudinal ligament. Operative stabilization of unstable fractures, especially pseudarthrosis, of the odontoid process was performed in the main by dorsal immobilization (blocking) at C1/C2 (pelvic bone chips/wiring), whereby the residual rotational limitation was only of moderate degree and well tolerated subjectively. Two patients in whom stabilization was achieved in this way developed secondary ossification of the old pseudarthrosis of the odontoid process. In 2 cases the operation was carried out by the transbuccal route, again with the use of pelvic bone chips. Operative stabilization below C2 was performed 15 times using the ventral approach only, namely 13 times by Cloward's method and twice by Caspar's method. A combined ventrodorsal approach was used a total of 13 times in patients with severely damaged dorsal ligaments; here we made use ventrally of autologous pelvic bone chips, dorsally of wire osteosynthesis. The results were in the main good in respect of repositioning, uniformly good in respect of stability. In the great majority of cases with medullary or radiculomedullary deficits, the operation resulted in complete healing or at least an improvement, namely in 75% of patients with lesions of the odontoid process and in 81% of those with lesions below C2. In the second part of the study, the advantages and disadvantages of the various methods are set out and discussed in the light of recent advances and in particular of operative experience with tumours in the region of the cervical spine.

Adult↗
PubMed1989

[Rehabilitation following surgical treatment of disk hernia].

This expose is based on the author's own experience of 5000 patients treated by microsurgery for lumbar disk hernias together with 400 given similar treatment for cervical disk hernias. The details of the operative technique described are limited to those with a bearing on the postoperative measures and results. These are of particular interest along with the patients' subsequent recuperation and rehabilitation. In conclusion, the author briefly compares his technique with a number of alternative methods.

Cervical Vertebrae↗
PubMed1988

Intrathecal infusion test and decrease in shunt revisions and infections.

The intrathecal infusion test leads to a more accurate diagnosis of communicating hydrocephalus, and is useful in identifying those patients with insufficient cerebrospinal fluid (CSF) absorption who are most likely to improve after a shunt operation. Furthermore, shunt function can be evaluated by assessing the CSF absorption of shunt-operated patients in the same way. Some patients do not improve after surgery because of irreversible or shunt-independent neurological and radiological signs, while the postoperative infusion test demonstrates a normal shunt function. The clinical condition and neuroradiological picture of such patients cannot be improved by shunt revision if the implanted shunt already allows a normal CSF outflow. By means of infusion tests the number of patients who need a further operation can be reduced, with a consequent drop in shunt infections, a very welcome aspect especially in pediatric neurosurgery. In our department 298 infusion tests were carried out over a seven-year period, and a decrease in shunt revisions and infections could be observed.

Adult↗
PubMed1988

Peritoneal drainage of chronic subdural hematomas in older patients.

Most patients with chronic subdural hematoma are successfully treated with trephination and external drainage. However, hematomas with thick membranes may persist or recur, needing reoperation or major surgery such as craniotomy with membranectomy. In 14 patients aged over 60 years, internal peritoneal drainage of the hematoma by a low-pressure shunt system proved to be a reliable method of treatment with the following advantages: rapid neurological improvement; immediate mobilization; little stress for the patient; no recurrence; disappearance of the membranes; and slow and well-tolerated cerebral reexpansion without hypotension. Successful use of this method has been reported previously in children, but not in adults.

Chronic Disease↗
PubMed1988

[Treatment of atypical post-traumatic and postoperative facial neuralgias by chronic stimulation. Apropos of 2 cases, with review of the literature].

This article describes the case of two patients suffering from deafferentation pain after surgery or traumatic lesions in the area of the peripheric trigeminal branches on the Gasserian ganglion. Chronic electrical stimulation by an electrode implanted in the Gasserian ganglion led to a good permanent result in both cases, within a follow-up period of one year and one year and a half, respectively. The pre-operative test was carried out percutaneously via the foramen ovale, the definitive implantation by surgery with subtemporal access. This method can only be used when at least part of the ganglion cells of the Gasserian ganglion are intact. According to identical observations by other authors, it is mostly adequate for surgical and traumatic trigeminal lesions, whereas for pain due to herpes zoster, the stimulation of specific thalamus nuclei is a much better method.

Electric Stimulation Therapy↗
PubMed1986

[Neurosurgical aspects of frontobasal injuries with cerebrospinal fluid fistulas: experience with 205 operated patients].

Over a period of 15 years the author operated on 205 patients with traumatic frontobasal CSF fistulas. In one third of these cases, exploration had to take place within 24 hours because of cerebral compression or a direct open injury. Craniotomy enables the surgeon to repair the concomitant neurosurgical lesions frequently found (57%) as well as the often multiple (56%) or bilateral (35.3%) fistulas. As regards surgical technique, the important points are: protection of the brain thanks to the use of magnification, the best possible approach, lumbar puncture during surgery to relieve pressure, sufficient cerebral debridement and in the paranasal sinuses, reliable closure of the fistula (duraplasty and sometimes additional plastic closure of the bony defect), and consideration of the latest findings of neuroanaesthesia, endocrinology etc. Nearly two-thirds of the patients operated were able to resume work completely.

Adult↗