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H A Dreesbach

Publications and source records attributed to H A Dreesbach.

9 recordsLinked to original sources
PubMed1987

[Continuous block of the celiac plexus].

We describe a new method for the insertion of an indwelling catheter into the region of the celiac ganglion in order to achieve long-lasting pain relief. A simple nylon catheter, of the type usually used for performing epidural catheter techniques, is placed into the prevertebral space opposite the first lumbar vertebra. The applications of the catheter were tested in a prospective study. Catheter insertion was performed in five patients suffering from carcinoma or pancreatitis. The catheter remained in place for an average of 5.8 days. The new technic was found to be successful not only for pain therapy but also to be a useful supplement for anaesthesia during laparotomy.

Adult↗
PubMed1986

[Additional examinations for ascertaining the diagnosis of multiple sclerosis].

The relevance of additional findings was examined in 50 patients in whom multiple sclerosis had been diagnosed. Magnetic resonance (MR) technique revealed morphological changes in 49 patients (688 foci), whereas CT scan visualised foci with modified enhancement in 35 patients only (133 foci) (70%). Oligoclonal antibodies were found in the CSF of 96% of the patients as pointers towards the inflammatory immunological process. Enhanced daily IgG production was seen in 57-70% of the patients, whereas in 52% stimulated lymphocytes were identified in the CSF. Total protein content and cell count in the CSF differed in only 22 and 26%, respectively. Functional deterioration of the myelin sheath resulted in 72% of MS patients in an increased latency of visually evoked potentials. Hence, oligoclonal antibodies in the CSF and multiple foci revealed by MR are the most reliable additional findings in MS and should be considered as essential aids to confirm the diagnosis. A modified schema is suggested in which CT is replaced by MR and the proof of oligoclonal antibodies is given a higher ranking. Pathological changes in evoked potentials are relevant only if clinical symptoms are absent. Sensitivity disturbances and manifestations of brain stem disorders are somewhat less significant.

Adult↗
PubMed1986

Cerebral haemorrhage in arteriovenous malformation associated with Klippel-Trenaunay syndrome.

The computed tomography, magnetic resonance imaging and angiographic findings are described in a patient with Klippel-Trenaunay syndrome, who also had a cerebral haemorrhage from an arteriovenous malformation. The resulting aphasia disappeared completely after resorption of the haemorrhage. In this syndrome, the occurrence of a cerebral angioma has not previously been mentioned in the literature.

Adult↗
PubMed1985

Presentation of bilateral thalamic infarction on CT, MRI and PET.

Paramedian thalamic structures and part of the upper midbrain are frequently supplied by posterior thalamoperforating arteries originating from one common trunk. Local impairment of flow entails a bilateral more or less symmetric thalamic infarction with varying involvement of the midbrain. Diagnosis usually can neither be firmly established on clinical grounds nor by angiography alone. In the present series of four patients the two cases observed before the CT era were diagnosed correctly only at autopsy. Only one patient presented the classical syndrome of hypersomnia, thalamic dementia, and oculomotor nerve paralysis, while in the others clinical signs were probably masked by serious impairment of consciousness. In two cases X-ray computed tomography and magnetic resonance tomography (one case) afforded precise definition of infarct localization and size. Infarction in the described terminal vascular supply territory may be detected more often by these modern diagnostic techniques than anticipated from previous clinico-pathological experience as the underlying cause of coma in the elderly-a group of patients at particular risk for low-flow states. Positron emission tomography repeat studies with 18F-2-fluorodeoxyglucose (one case) revealed complex disturbances of brain energy metabolism; correlative analysis of clinical function and metabolic patterns during the course of the disease may not only advance individual prognostication but also contribute to the understanding and localization of brain function.

Adult↗
PubMedDate not supplied

Review and case report: primary melanoblastosis of the leptomeninges.

A case of primary diffuse leptomeningeal melanoblastosis in a 46-year-old male is reported. His symptoms included headaches, transient hemiparesis, epileptic seizures and a progressive psychosyndrome. CT brain scans showed a slight enhancement of density in the subarachnoidal space. The disease was diagnosed by CSF cytology, using light microscopy, electron microscopy, autoradiography and cell culture. Systemic combined chemotherapy using Cisplatinum, DTIC, and Vindesine was without any significant response and he died 18 weeks after onset of the first complaints. Autopsy showed a diffuse infiltration of the entire leptomeninges by melanotic melanoblastoma cells invading the sagittal superior sinus. A thorough dissection including the orbital contents and skin nevi failed to reveal a primary tumor outside the CNS.

Arachnoid↗