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Biomedical subjects

D Stula

Publications and source records attributed to D Stula.

9 recordsLinked to original sources
PubMed1992

[Severe herpes simplex encephalitis: course 15 years following decompressive craniotomy].

Decompressive craniotomy with brain biopsy was carried out in two patients with herpes simplex virus encephalitis (HSE). In both cases the indication for surgery was based on the clinical picture of coma with rapidly progressive hemiparesis and on the computer tomographic finding of a large space-occupying lesion of in the temporal lobe accompanied by brain stem compression not controllable by medication. Both patients were treated with a standard dosage of vidarabine (Ara-A 15 mg/kg/24 h) and corticosteroids after the operation. The improvement attained by surgery was very impressive in both cases. The massive neurological deficits (which also included subtotal aphasia in one case) regressed to a minimum in the following weeks. Both patients were followed up at yearly intervals for 15 years. They are now 36 and 76 years of age, both in a very satisfactory condition. Our observations show that decompressive craniotomy with duraplasty may be the crucial therapeutic measure in HSE with brainstem compression not controllable by medication.

Adrenal Cortex Hormones↗
PubMed1992

[Decompressive craniotomy and its effect on recovery and rehabilitation of the patient].

The rehabilitation of patients who have to be operated on because of severe craniocerebral trauma and in whom the roof of the cranium must be removed because of severe post-traumatic cerebral oedema, is extremely difficult. The slow rehabilitation and recovery of these patients, who also show psychological changes in most cases, must be attributed to the pathological intracranial conditions which have arisen in consequence of large defects in cranial bones. A causal correlation between severe pathological intracranial conditions, which have arisen not only from trauma but also from bone flap decompressions, and protracted postoperative recovery and difficult rehabilitation has only recently been established. Our experience has shown that rapid rehabilitation of the injured person can only be expected after skullcap reconstruction and normalization of intracranial conditions.

Adult↗
PubMed1979

[Decompressive craniotomy in herpes simplex encephalitis].

Two patients with herpes simplex encephalitis (HSE) underwent decompressive craniotomy with brain biopsy. The indication for the procedure was in both cases computertomographic finding of a large, space-occupying process situated in the temple lobe with clinical picture involving febrile state, progressive hemiparesis, and subconsciousness. The patients were treated with standard doses of Ara A and methylprednisolone immediately after operation. In both cases, the improvement was very impressive. The massive neurological deficits -- in one case even including subtotal aphasia -- disappeared almost completely in the weeks following operation. 6 months later both patients underwent cranioplasty. These observations show that decompressive craniotomy with dilatation of the dura represents a decisive therapeutic approach in the case of HSE when the pressure of the brain cannot be brought under control by medical treatment. Computertomography proved to be of particular diagnostic value and assists in taking decisions for meaningful surgical treatment.

Adult↗
PubMed1979

[Brain abscess after odontogenic infection].

Dentogenous infections are among the most frequent in the maxillo-facial area. Case report of a dentogenous-pyogenous-actinomycotic mixed infection, with the complication of a secondary brain abcess is given. Consecutively, the patient became an invalid. Origin and pathogenesis of the disease are described. Also, liberal incision and drainage as a preventive measure are recommended.

Actinomycosis↗
PubMed1979

[Operative therapy of malignant intracranial tumors by the CO2 laser. Initial results after vaporization of the tumors].

From the Clinic of Neurosurgery of the Kantonsspital Basle a report is given over a one year-experience with a CO2-Sharplan 791 Laser (Prod.: Laser Industrie Ltd., Israel). The excellent technical qualities, as described by other authors, have been confirmed. 11 patients with malignant glioma received all the same treatment (intratumoral partly resection and "vaporisation" of the tumor-bed with Laser-ray followed by radiotherapy with 6000 rad.). It showed that the post-operative course and the definite prognosis of the disease is not decisive different from the results of an operative treatment with conventional methods. Only 2 (18,1%) patients were in a satisfactory condition fourty weeks after operation and radiotherapy. 5 patients (45,4%) died in the first 10 months after operation and radiotherapy and 4 (36,3%) had a relapse 6 months after surgical intervention.

Adult↗
PubMed1977

[Herpes simplex encephalitis. A case report with support of the diagnosis by means of brain biopsy].

The pathogenesis, differential diagnosis and therapeutic problems of herpes simplex encephalitis are discussed. Early diagosis of herpes simplex as a leading, and possibly the sole, cause of acute necrotizing encephalitis is crucial to effective management. Decompressive craniotomy in the presence of fulminating cerebral swelling associated with acute onset of the disease is of value as an adjuvant to definitive therapy with antiviral agents.

Biopsy↗
PubMed1976

[Pre-operative embolisation of vascular tumours in the head (author's transl)].

Trans-vascular, pre-operative embolisation in order to reduce blood flow was carried out with excellent results in a patient with a naso-pharyngeal fibroma, and with relatively good results in a patient with a pterion meningioma. This technique can be carried out following the diagnostic angiogram through the same catheter; it reduces operative blood loss, improves haemostasis and the surgeon's view of the operative field. The method can be used simply and without risk in any case where the tumour blood supply is derived exclusively or predominantly from branches of external carotid artery.

Adult↗