PubMed Health⌕ Search

Biomedical subjects

H Majchrzak

Publications and source records attributed to H Majchrzak.

At least 19 recordsLinked to original sources
PubMed2002

"True" aneurysm of the posterior communicating artery as a possible effect of collateral circulation in a patient with occlusion of the internal carotid artery. A case study and literature review.

"True" posterior communicating artery (PCoA) aneurysms are extremely rare. A case of a 63-year-old patient with a ruptured "true" aneurysm of the right PCoA associated with the occlusion of the right internal carotid artery is presented. For nine years before he suffered from subarachnoid hemorrhage, the patient had developed symptoms of transient ischemic attack (TIA) due to the occlusion of the right internal carotid artery. The left vertebral angiogram demonstrated a "true" right PCoA aneurysm and collateral flow from the right posterior communicating artery to the right internal carotid artery. The right internal carotid system was also fed by collateral circulation from the left carotid artery through the anterior communicating artery. Transcranial colour-coded real-time sonography (TCCS) demonstrated increased velocity and turbulent blood flow in both communicating arteries. The patient was operated on and the aneurysm was clipped successfully. This case report suggests that the blood flow disturbances resulting from the collateral circulation through the PCoA could be a conductive factor in the formation and development of the aneurysm. This is the first described case of a "true" aneurysm of the PCoA coexistent with the occlusion of the internal carotid artery.

Aged↗
PubMed2000

Approaches to posterior circulation aneurysms and results of the operations.

Surgical approaches and operative results in 32 operations of aneurysms of the vertebrobasilar system are presented. The orbitozygomatic and temporopolar approach was used for aneurysms of the bifurcation of the basilar artery lying high in the interpeduncular fossa. In aneurysm which neck was located less than 10 mm above or less than 5 mm below the anterior and posterior clinoid processes the pterional transylvian subtemporal and pterional anterior temporal approaches were performed. A large aneurysm with the neck lying 5 mm below the line connecting the anterior and posterior clinoid processes was operated on via pterional transcavernous approach. The used approaches made it possible to clip the aneurysms. Good and very good results were obtained in 82 per cent of cases. The perioperative mortality was 9 per cent.

Adult↗
PubMed1999

Occlusion of radicular arteries - reasons, consequences and anastomotic substitution pathways.

AIM OF STUDY: To investigate the cause of radicular artery occlusion. METHOD: Fifty specimens of spinal cords were taken at postmortem from individuals in whom no symptoms of spinal cord and spine injuries were present in life. The spinal cord arterial system was filled with colour contrast material and then each radicular antery was studied individually at 5 - 25 operative microscope magnification. RESULTS: Two hundred and fifty two anterior radicular arteries joining the anterior spinal artery and 525 posterior radicular arteries joining the posterior spinal arteries were examined. There were five obstructed vessels: four were anterior radicular arteries including the artery of Adamkiewicz and one of the initial branches of the spinal artery originating from the vertebral artery. CONCLUSIONS: As the presented examples show, the formation of a fully efficient collateral circulation is possible.

Adult↗
PubMed1997

The accessory anterior cerebral artery: case report and anatomic analysis of vascular anomaly.

BACKGROUND: The term "accessory artery" was formulated to describe one of the developmental anomalies of the middle cerebral artery. This anomaly consisted of the incidence of a vessel that branched off close to the anterior communicating artery and supplied a part of the cortex in the region of the middle cerebral artery vascularization. METHODS: A panangiography of the cerebral vessels was carried out, using the subtraction method, on a woman who suffered from subarachnoid hemorrhage. An aneurysm of the anterior communicating artery and developmental anomaly of the right anterior cerebral artery were found. During the aneurysm operation, the existence of the developmental anomaly was confirmed. It was revealed also during a control angiography. RESULTS: An atypical branch of the right internal carotid artery was found branching off from section C2, and passing below the right optic nerve and the anterior communicating artery. This branch ended with a division into the orbitofrontal and frontopolar artery. CONCLUSIONS: The atypical branch of the internal carotid artery that partly performs the function of the existing proper right anterior cerebral artery, has been defined as the accessory anterior cerebral artery.

Adult↗
PubMed1992

[Use of the Nd:YAG laser in surgical treatment of intracranial tumors].

The Nd:YAG laser was used between January 1989 and March 1991 in 63 cases of intracranial tumours, including 32 meningiomas, 16 gliomas (including 11 glioblastomas), 8 acoustic neurinomas, 11 metastatic brain tumours. In 76.2% of cases very good results were obtained. The Nd:YAG laser was found to be particular value in the treatment of vascular intracranial tumours, especially meningiomas and metastatic tumours. The ability of the Nd:YAG laser to shrink and devascularize these tumours, was useful in neurosurgical operations. The no-touch technique, minimal or no thermal effect on surrounding tissues, better haemostasis and precision allow for easier removal of acoustic nerve tumours. The Nd:YAG laser is very useful in the operations close to the very important for life areas of the brain. The major advantages of laser include reduction of mechanical trauma, reduction of blood loss, and more radical removal of intracranial tumours.

Adult↗
PubMed1992

[Surgical treatment of cerebral hematoma using an endoscopic method].

In the period from January 1990 to March 1991 in the Neurosurgery Department, Mining Industry Health Service Hospital in Sosnowiec 21 operations of evacuation of supratentorial intracranial haematomas were carried out by the endoscopic method using a neuroendoscope produced by K. Storz. The indication to this operation was a serious condition of the patients up to 10 points of the Glasgow scale, strictly limited extent of haematoma and ventricular system shifting over 5 mm in computed tomography. The mass of the haematoma could be evacuated in 70-90% and the patients were spared extensive craniotomy. Two patients had reoperations due to renewed haematoma formation. 48% of the patients left the hospital in good condition without neurological deficits and 42.5% had focal neurological signs.

Adult↗
PubMed1992

[[Microsurgical treatment of cerebral hemangioma].

The authors present the results of microsurgical treatment of 16 patients with intracranial arteriovenous malformations. The applied technique made possible considerable sparing of healthy brain tissue and closing feeders closely to haemangioma. The patients in I to III degree according to Spetzler's scale left the hospital in good condition. The patients in IV and V degree in 4 cases were operated on twice and in control examination have presented mild neurological dysfunction. Severe disability was observed only in 1 patient. Control angiography revealed in 3 of these patients the presence of small parts of haemangioma.

Adolescent↗
PubMed1983

Possible significance of juvenile oral venous angioma as marker of intracerebral vascular lesion.

This 10-year-old child suffered a hemorrhage into the right parietal lobe, the result of a ruptured arteriovenous angioma. From birth, the boy had a venous angioma of the mucous membrane of the cheek, lower lip, and hypoglossal area on the right side. The coexistence of these two vascular defects is most unusual, and venous angioma in early life may suggest the presence of cerebral angioma.

Cheek↗
PubMed1980

[Transient involuntary movements after severe cranio-cerebral trauma].

In a patient rhythmic, coarse tremor of the right hand and fingers 5/sec. was observed 5 weeks after severe craniocerebral injury. The tremor occurred at rest and increased during movements but disappeared in sleep. In view of associated mask-like facial expression, salivation, cog-wheel sign in the right upper extremity the diagnosis of traumatic, hemiparkinsonian syndrome was made and treatment with Nacom was started. Normal concentration of homovanilic acid in the cerebrospinal fluid and lack of effect of Nacom treatment failed to confirm this diagnosis. Nine weeks after trauma a rotatory movement of the right upper extremity appeared additionally. It is to be accepted that this was an involuntary movement poorly classificable which disappeared spontaneously.

Adult↗
PubMed1979

Concentration of homovanillic acid and 5-hydroxyindoleacetic acid in the ventricular cerebrospinal fluid of patients with obstructive hydrocephalus.

In 12 patients with different posterior fossa tumours the concentrations of homovanillic acid (HVA) and of 5-hydroxyindoleacetic acid (5-HIAA) were measured in cerebrospinal fluid from the lateral ventricles. All patients had obstructive hydrocephalus. Patients with a clear increase of 5-HIAA/HVA ratio in the ventricular CSF have died subsequently. This feature may have a diagnostic value, and indicates the prevalence of serotoninergic neurones in patients with obstructive hydrocephalus with fatal course after surgery.

Adult↗
PubMedDate not supplied

[Clinical course and results of surgical treatment of epidermoid and dermoid tumors].

Seventeen cases (7 males and 10 females) of intracranial epidermoid tumours and one case (a male) of intracranial dermoid tumours were described. The patients with epidermoids represented 1.7% and the patients with dermoids represented 0.1% of all patients operated from January 1989 to July 1998 because of intracranial tumours. The average age of the patients with epidermoid tumours was 44.5 and ranged from 17 to 69 years whereas in patient with dermoid it was 19 years. Twelve epidermoid tumours (70.6%) and one dermoid tumour (100%) were located at the basal cisterns of the brain, i.e. 4 epidermoid tumours were located at the cerebello-pontine angle, 4--in the suprasellar region, 3 (2 epidermoid and 1 dermoid tumours)--in the parasellar region, and 2 in the retrosellar region. Four epidermoid tumours (23.5%) were found intraventricularly while only one (5.9%) located in the cerebral hemisphere. Mainly symptoms of cranial nerves (II, V, VII, VIII) dysfunction were observed among the patients. The average duration of the symptomatic period was 3 years. All operations were performed in a single stage using microneurosurgical techniques. Radical removal was possible in nine cases (50%) while in other nine cases the removal was subtotal. Two patients (11.1%) died in the postoperative period. Mean follow-up for the patients was 3.3 years. Among the patient three (16.7%) had a recurrence of the tumor and were operated on again. In 14 patients (72.2%) the results were very good and good. There was no difference of statistical significance of the results between patients with total and subtotal removal of tumours.

Adolescent↗
PubMedDate not supplied

[Prognostic factors in patients with intracerebral hematoma caused by ruptured middle cerebral artery aneurysm].

In a retrospective study, the authors analysed surgical outcomes in patients after intracerebral haemorrhage (ICH) as a result of ruptured middle cerebral artery (MCA) aneurysm. Between January 1989 to June 1997, 836 patients with ruptured aneurysm were admitted. Of these 207 (24.8%) patients had MCA aneurysm. Sixty-seven patients (32.4%) with MCA aneurysm had ICH. The types of ICH were classified into three groups according to CT findings on admission: A) temporal ICH (with or without a minor SAH); B) intrasylvian haematoma (with or without a minor SAH); C) ICH with diffuse SAH (SAH with cisternal clots on the side contralateral to the haematoma). The outcome was assessed according to the Glasgow Outcome Scale. Each patient was classified as having made either a good recovery including moderate disability (a favourable outcome) or a poor recovery including severe disability, vegetative state, or death (an unfavourable outcome). Overall, 31 patients (46.3%) had a favorable outcome (good recovery in 12 (17.9%) cases and moderate disability in 19 (28.4%) cases), and 36 patients (53.7%) had an unfavourable outcome (18 (26.9%) suffered severe disability, 4 (5.9%) remained in vegetative state, and 14 (20.9%) died. A temporal ICH occurred significantly more often in patients with favourable outcomes (67.7%) (p < 0.01). In patients with favourable outcomes the incidence of Grade I and II was higher (51.6%) than that in patients with unfavorable outcomes (19.4%) (p < 0.025). Surgical complications were significantly higher in patients with unfavourable outcomes (52.8%; p < 0.01). Patients who developed more than 25 ml of ICH had significantly worse outcomes (p < 0.05). Factors that could be used to predict a favourable outcome include temporal ICH, WFNS Grade I or II, absence of a surgical and postoperative complication, and a haematoma volume less than 25 ml.

Adult↗