Biomedical subjects
Publications and source records attributed to G Pendl.
This is a report of a case of a serious side effect following lumbar radiculography with the water soluble contrast medium Iopamidol. The complication consisted of a generalized seizure after an episode of myoclonic jerking of the legs. This was the first complication in a series of 1070 lumbar and cervical myelograms with this medium.
Personal experience with surgical exploration and total resection or evacuation of pineal and midbrain mass lesions in 20 pediatric patients from a total material of 52 cases demonstrate the efficacy of modern microsurgical techniques. Microtopography indicated the choice of the most suitable approach to these deep-seated lesions. The infratentorial supracerebellar approach proved to be the ideal exposure, except in one case of a lesion in the interpeduncular cistern, where a subtemporal approach was chosen. There was only one death as a consequence of the operation in a case of an extensive medulloblastoma; in all the other cases, no increase in morbidity occurred after surgery. Duration of post-operative observation with individual survival times will be demonstrated.
On the basis of anatomical studies in fresh cadavers, formalin fixed brains and clinical experiences in 40 surgically treated cases of pineal and midbrain lesions the most important surgical approaches with their anatomical peculiarities as well as pitfalls are demonstrated. Emphasis is given to the great vein of Galen and its tributaries as major obstacle in microsurgery in this area.
Mass lesions of the pineal gland, quadrigeminal plate, posterior third ventricle and midbrain are grouped together as pineal region lesions. The various methods of neuroimaging should not only help to localise and circumscribe these lesions, but should also suggest their quality and nature, i.e. cystic parts, delineation and possible histology. Also, the pathomorphological pattern with respect to the position of the aqueduct and the direction of growth towards the third ventricle and trigone of the lateral ventricle plays an important role in deciding which approach is possible and most suitable. Of major importance are the deep vascular structures and the vasculature of the lesion itself. The study is based on 24 cases of the pediatric age group from a total of 52 observed cases.
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Within a period of 13 months a 24-year-old male student experienced four attacks of subarachnoid haemorrhage. An intradural-extramedullary haemangioma at the level of the second thoracic segment was found to be the cause of the repeated bleeding.
It has been established that trauma and infection are the most important causes of "optochiasmatic" arachnoiditis. Only a few cases have been reported in the literature of collateral optochiasmatic arachnoiditis caused by tumors. Two cases of craniopharyngioma with collateral optochiasmatic arachnoiditis are described here. The following was deduced: 1) atypical complex visual field defects in which the exact location of the tumor is known may be caused--at least partially--by a collateral optochiasmatic arachnoiditis 2) whenever optochiasmatic arachnoiditis is suspected a tumor as a possible cause should be ruled out.
The case of a 7 year-old boy with 'bobble head doll syndrome' associated with a cyst in the third ventricle is reported. This movement disorder appears in early childhood and consists mostly in a rhythmic to-and-fro bobbing of the head and eventually of the trunk. As in three previously described cases, this case showed only slight decrease of the 'tic' after partial removal of the cyst by transcortical exploration of the third ventricle. In an inquiry and a survey of the literature, 17 cases with bobble head doll syndrome were collected. The average age of the described cases was 7 years at time of diagnosis. In 13 cases a slow-growing cyst or mass in the anterior part of the third ventricle of close to this region was found. There was no case observed with an acute lesion, in 3 cases it was thought an aqueduct stenosis should be the cause, and in 1 case the cause was unknown.
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