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Biomedical subjects

D Kömpf

Publications and source records attributed to D Kömpf.

At least 91 records · Page 5Linked to original sources
PubMed1991

Doppler CO2-test in patients with vertebrobasilar ischemia.

The pathogenesis of vertebrobasilar ischemia (VBI) is still uncertain. Embolism and systemic hypotension have been discussed as possible causes. We evaluated the basilar arteries of 35 VBI-patients by transcranial Doppler-sonography at rest and under hypercapnic conditions and compared these findings with the basilar flow velocities in 10 healthy volunteers matched by age. We found no difference between the controls and the VBI-patients for the basilar flow velocities at rest. Under hypercapnia (end-tidal CO2-concentration 8.5%), the basilar blood flow velocities in the healthy controls increased by an average of 53.0% but only by 32.3% in the VBI-patients (p less than 0.005). The reduction of CO2 dependent vasomotor reactivity was observed in all VBI-patients, except in patients with infarction in the posterior cerebral artery area, possibly indicating a different pathogenic mechanism of stroke. The results in all other patients revealed no obvious correlation to the clinical course or angiographic or dopplersonographic findings. As CO2 dependent vasomotor reactivity and brain perfusion pressure dependent cerebral autoregulation have similar mechanisms, we conclude that systemic hypotension might play an important part in VBI.

Aged↗
PubMed1991

Clinical relevance of intraplaque hemorrhage in the internal carotid artery.

In this study the correlation between hemispherical ischemic symptoms and the presence of intraplaque hemorrhage in carotid plaques has been evaluated. 38 patients who had undergone carotid endarterectomy were examined clinically and the specimens obtained from operation were studied morphologically. The patients were divided into two groups, asymptomatic and symptomatic regarding the territory of the supplying carotid artery. The presence of intraplaque hemorrhage, shown by Ladewig's Trichrom stain, as well as evidence of iron, immunohistochemical stain of hemoglobin and native fluorescence microscopy was noted, and, according to their extension, classified into three degrees. As a result, there was neither a correlation between history of ischemic brain symptoms and the presence of intraplaque hemorrhage, nor between clinical symptoms and extension of hemorrhage. The plaques were high degree stenotic (greater than 80%) in most of the patients and showed various degenerative changes. In 97% of all plaques with hemorrhages surface defects were seen. Our results confirm that intraplaque hemorrhage is one out of a series of pathological events which occurs during advanced atherosclerosis. Blood inflow from the lumen through an already damaged plaque surface is a common event and a correlation with the onset of symptoms is unlikely.

Arteriosclerosis↗
PubMed1991

[Presenile dementia in xeroderma pigmentosum].

Neurological manifestations of xeroderma pigmentosum, a rare autosomal recessive neurocutaneous syndrome, are variable. The association with progressive mental retardation, usually with onset in childhood, is well known. We present a case of x.p. with progressive presenile dementia. This combination has, to our knowledge, not yet been reported in the literature. Although no hints on another aetiology have been found, the coincidental combination of x.p. with M. Alzheimer has to be taken into consideration. CT scan and MRI showed a marked cerebral atrophy.

Atrophy↗
PubMed1990

Surgical removal of pontomesencephalic cavernous hemangiomas.

Cavernous hemangiomas of the brain stem are usually discovered accidentally during evacuation of a hematoma, and successful surgical treatment of these lesions is seldom achieved. With the increasing use of magnetic resonance imaging, the presence of a cavernous hemangioma can be detected before surgery, allowing an elective surgical approach. We successfully removed pontomesencephalic cavernous hemangiomas from 2 patients and pontomedullary hemangiomas from 2 others. Elective surgery was performed with perioperative bimodal monitoring of somatosensory and auditory evoked potentials. Performing surgery soon after the hemorrhage minimizes the risk of additional postoperative neurological deficit, since surgical excision is facilitated when the hematoma is not completely organized. Pontine hemangiomas are approached via the 4th ventricle. Mesencephalic hemangiomas are removed by a midline supracerebellar approach when they are lateralized by using a subtemporal approach. The lesion can be removed through a small incision in the brain stem at the site of the lesion. The favorable results, which include marked improvement of preoperative neurological deficits and documentation of complete removal of the lesion by magnetic resonance imaging, support a more aggressive approach to the treatment of symptomatic cavernous hemangiomas of the brain stem. Further investigation of the natural history of these lesions is mandatory.

Adolescent↗
PubMed1990

[Drusen papilla with vision disorder and pathologic visual evoked potentials].

Six cases of optic nerve head drusen ophthalmoscopically are reported. Five of these had pathological latencies of the P 100 potentials on VEP examination. Only three of the patients had subjective visual complaints; all six, however, had variable visual field defects. Optic nerve head drusen are an important differential diagnosis, which can be readily established especially in those younger patients who need neurological and ophthalmological examination because of visual disturbances and pathological VEP responses.

Adult↗
PubMed1989

[Acute hemorrhage and ischemic necroses in hypophyseal tumors: hypophyseal apoplexy].

Acute enlargement of pituitary adenomas due to haemorrhage or ischaemic necrosis in the tumour was described as "pituitary apoplexy" by Brougham et al. in 1950. Since then, more than 200 cases have been reported, but--especially in the German literature--the syndrome has caught only little attention. Therefore, in a series of 12 own patients, typical findings and clinical characteristics are demonstrated and the literature is discussed. 9 patients had a haemorrhage into the tumour, 3 an acute ischaemic necrosis. The guiding symptom was the acute onset with ophthalmoplegia (11 of 12 patients). Only in one case the adenoma was known before the apoplexy. Other symptoms were headache, blurred vision, drowsiness and, in severe cases, hemiparesis, coma, and hypothalamic disorder. Most important is the acute endocrinological substitution with hydrocortisone; this may be life-saving. Neuroophthalmological recovery depends on early operation: cases of oculomotor palsy require an operation within the first 2 weeks after the acute event. An emergency operation is required only by an acute amaurosis. In general there will be enough time for careful clinical endocrinological and radiological investigations.

Adenoma↗
PubMed1988

[Myotonia congenita with familial spastic paraparesis].

An association of myotonia congenita and hereditary spastic paraplegia has not been reported up to now. We present three cases in one family, who suffer from this combination of syndromes. There are no hints for a pathophysiological connection between these diseases of different systems. A combination of autosomal dominant myotonia congenita and autosomal recessive spastic paraplegia is supposed. Under this hypothesis the risk for an association of the syndromes in the last generation of the reported family with two affected patients is 1/36. A coincidence of these two hereditary diseases seems to be possible.

Adult↗
PubMed1987

Eye movements and vestibulo-ocular reflex in the blind.

To assess the effect of chronic deprivation of visual feedback, 21 blind patients underwent clinical and electronystagmographical examination. Patients with congenital blindness were characterized by spontaneous eye movements, inability to consciously move the eyes and absence of the vestibulo-ocular reflex (VOR), whereas eye movement abnormalities were practically absent in those with blindness acquired late in life. Active visual experience, at least in early life, seems to be crucial for the development of eye movements and VOR adjustment.

Adult↗
PubMed1986

[Dynamics of eye movements in paralytic strabismus].

The characteristic clinical signs of paralytic strabismus can be confounded by phenomena concerning either the ipsilateral and/or the contralateral eye, the latter particularly occurring when fixating with the paretic eye. Specific clinical and EOG-phenomena and the underlying dynamic mechanisms of the peripheral oculomotor apparatus in acute and chronic paralytic strabismus are described.

Abducens Nerve↗
PubMed1985

[Acute cerebellar encephalitis in adulthood].

Two cases of rare adult cerebellar encephalitis are reported presenting the distinguishing features of acute onset of cerebellar ataxia, distinct ocular oscillations (opsoclonus, ocular flutter, macro square wave jerks) and generalized myoclonic jerks. The EOG-analysis of the cerebellar oculomotor disorder is emphasized. The course is usually benign ("benign encephalitis") differing from the childhood form only in age of onset. Fatal courses are rare and the histopathologic findings in one case suggest mild encephalitis with diffuse perivascular lesions accentuated in the cerebellum, thus not allowing clear clinicotopodiagnostic correlations.

Acute Disease↗