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Biomedical subjects

E Frankiewicz

Publications and source records attributed to E Frankiewicz.

At least 19 recordsLinked to original sources
PubMed1991

Medical and surgical treatment of intracerebellar haematomas.

15 cases of intracerebellar haematomas [11 spontaneous, 2 traumatic and 2 unclear] were presented. Hypertension was thought to be a main risk factor in 91% in 11 of the spontaneous cases. 11 cases were treated medically. They were usually conscious, scoring not less than 13 in GCS with subacute or chronic picture of illness and harbouring small haematomas below 3 cm in diameter situated almost always in the hemisphere and with no signs of ventricular dilation. Mortality in medically treated patients was 9% [1 case]. The remainder were discharged in good state, usually with no or only slight neurological deficit. Complete haematoma absorption took about 14 days. There were no signs of delayed hydrocephalus in subsequent CT scans. When the haematoma was large, more than 3 cm in diameter, located usually in the vermis or in the vermis and cerebellar hemisphere, sometimes with ventricular involvement, the clinical presentation was acute and required CT diagnosis and surgical evacuation without delay due to low and deteriorating conscious level. Postoperative mortality was 25%, but delayed mortality was 100%. Vertebral angiography was performed in all cases of spontaneous haemorrhage and was normal in 54%, revealed atheromatous changes in 36% and the signs of cerebellar haematoma in only 10%. Arteriovenous malformations were excluded from this study. The authors believe, that the benign course of intracerebellar haematomas is more frequent than it was considered previously and needs no surgical treatment in many cases.

Adult↗
PubMed1989

[Conservative treatment of intracranial hematomas and the dynamics of their resorption].

In 10 out of 63 patients with intracerebral haematomas treated conservatively the authors measured approximately the volume of haematomas by means of serial CT examinations during observation of their resorption. These were large and medium-size haematomas, from 20 to 70 ml in volume. The mean rate of resorption was from 0.7 to 1.0 ml daily. Gradual regression of mass effects was noted. All patients were on admission in a relatively good condition, conscious or only somnolent, with focal neurological signs. In some cases signs of increased intracranial pressure were present. Improvement of the general condition and neurological status was relatively rapid, even pronounced paresis and aphasia regressed in most cases. Two patients (3%) died of non-cerebral causes. It is believed that most intracerebral haematomas may be treated conservatively. The presence of mass effects, increased intracranial pressure or even a major neurological syndrome are not regarded as indications to operation if the state of consciousness is good and is not deteriorating. Even large and deeply situated haematomas may be resorbed without leaving a gross neurological deficit. A careful observation of the state of the patient, control CT investigations and the possibility of carrying out emergency operation in case of deterioration of the level of consciousness are indispensable for safe conservative treatment of these patients.

Adult↗
PubMed1989

[Erdheim's tumors in adults--diagnosis, treatment and therapeutic results].

The authors present a group of 27 adult patients aged over 25 years treated in the Department of Neurosurgery, Medical Academy in Warsaw in the years 1960-1985 for Erdheim's tumours. In most cases the first signs were visual disturbances and signs of raised intracranial pressure, and in only 48% of cases endocrine disturbances were additionally found. The basic diagnostic method in these cases was computerized tomography which indicates precisely the location of the lesion, its consistency and width of ventricles. All patients were treated surgically, the operative surgery was 14.8%. The authors believe that surgical treatment followed by radiotherapy is the best method of management of such tumours in adults.

Adult↗
PubMed1987

Cytostatics for acromegaly. Marked improvement in a patient with an invasive pituitary tumour.

A 21-year-old woman suffering from acromegaly was treated with transsphenoidal subtotal hypophysectomy (microscopy: acidophilic adenoma), followed by x-ray and bromocriptine therapy. Seven years later she was re-operated because of a partial bitemporal loss of vision, intracranial hypertension, and regrowth of the pituitary tumour seen on CT-scan. A large part of the invasive suprasellar tumour was then removed by transcranial approach. The neurosurgery was followed by cobalt radiotherapy and bromocriptine administration. Two years later, symptoms and signs of tumour growth reappeared. Administration of cytostatics, such as doxorubicin (Adriamycin) and lomustine (Belustine), resulted in distinct clinical improvement associated with a seven-fold decrease in the serum growth hormone concentration. The visual field became normal and the intracranial mass on a CT scan decreased markedly. As a result the patient was able to resume work.

Acromegaly↗
PubMed1981

Encephalomalacia in the distribution of the posterior cerebral and superior cerebellar arteries: the CT and radionuclide examination.

The case described concerns the clinical diagnosis of a vascular focus in the distribution of the posterior cerebral and superior cerebellar arteries. Up to now both carotid and vertebral angiography were required. Nontraumatic CT and radionuclide studies have allowed demonstration of the etiology of the disease in the occipital and cerebellar region without further neuroradiology examinations with contrast. Clinical diagnosis by using neuroradiological methods in the detection of infarct in the region of the posterior cerebral and cerebellar artery is seldom observed. The case of a vascular focus in the distribution of the posterior cerebral and superior cerebellar arteries was diagnosed using the above methods.

Cerebellum↗
PubMedDate not supplied

[Hydrocephalus as a sequel of hemorrhage from ruptured cerebral aneurysm in light of CT investigations].

In the years 1985-1987 CT studies were carried out in 182 patients after haemorrhage from ruptured intracranial aneurysm. The study was carried out before surgery or the patients were not operated on for various reasons. Hydrocephalus was found in 33 cases, that is 18.2%. The patients were divided into subgroups depending on the time of CT after haemorrhage and on the state according the Hunt-Hess classification. Since only a small per cent of cases fell into the I and II categories of the classification, one may state that posthaemorrhagic hydrocephalus is connected usually with worse condition of the patient. Early hydrocephalus was relatively rare. In only a part of the cases CT was done on the first day after haemorrhage and it was difficult to say whether the presence and amount of blood in the basal cisterns and over the convexity contributed significantly to the development of hydrocephalus. However, in half the cases with intraventricular bleeding hydrocephalus was present.

Adult↗
PubMedDate not supplied

[Neuroradiological studies in syringomyelia].

In the years 1973--1975 20 patients with syringomyelia were treated surgically. The surgical interventions were preceded by careful radiological examinations which was often indispensable for confirmation of diagnosis, establishing of indications to operation and choice of surgical method. On plain radiograms in 16 cases cervicothoracic scoliosis was found, in 11 cases the vertebral canal was dilated in its cervical part, in 6 cases atlanto-occipital malformations were disclosed. The basic diagnostic examination was ascending myelography which was performed in 17 cases. In 3 cases the contrast medium failed to pass to the atlanto-occipital junction because of marked dilatation of the spinal cord in the cervical part. In 9 out of the remaining 14 cases radiological findings were compatible with the diagnosis of Arnold-Chiari syndrome which was confirmed during the operation. In 1 case positive contrast central pneumoencephalography was performed demonstrating a communication between the 4 th ventricle and the cavity in the spinal cord. Early detailed neuroradiological diagnosis is indispensable in syringomyelia for early surgical treatment.

Adolescent↗
PubMedDate not supplied

[Clinical, electroencephalographic and cerebral computerized-tomographic findings in patients with ischemic stroke].

The clinical findings, EEG and CT examinations of the brain were compared at three time intervals in patients with ischaemic stroke. No evident correlation was found between the intensity of clinical signs, the intensity of EEG changes and the size of the ischaemic focus in the CT. It was observed that with increasing time interval after the onset of the disease the clinical state and EEG changes improved while the CT image was not changed or even became worse. In the observations a greater tendency clinical for improvement was found in the group of cases of lesions in the left parietal lobe than in those with lesions in the right parietal lobe. Another observation was that patients with ischaemic focus developing in brain with evidence of atrophy in CT had a much lower tendency for clinical improvement than those without brain atrophy.

Adult↗
PubMedDate not supplied

[A case of conservatively treated multiple brain abscesses].

A patient is reported with multiple brain abscesses in whom conservative treatment gave a good result. Attention is called to the small number of such cases described as yet. In accordance with the observations of other authors it is stressed that this treatment is possible only if repeated CT control examinations are available, and only if no raised intracranial pressure is present.

Adult↗
PubMedDate not supplied

[Conservative treatment of selected cases of chronic paracerebral hematoma].

The authors report an analysis of the course of 16 cases treated conservatively for paracerebral haematomas. The diagnosis was based on angiographic findings of computerized tomography (CT). Haematoma resorption was confirmed by CT. The follow-up was from 3 months to 6 years. The patients were in a general good condition without or with only transient signs of focal central nervous system damage, the thickness of the haematomas was never over 15 mm. In all cases the haematomas were resorbed, 15 patients feel well and lead an active life, in one case signs of organic brain injury developed connected with dilatation of the ventricular system and cortico-subcortical atrophy. In the light of the observed material and a literature review criteria are suggested which could indicate expected good effects of conservative treatment in such cases.

Adult↗