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Biomedical subjects

H P Molsen

Publications and source records attributed to H P Molsen.

At least 19 recordsLinked to original sources
PubMed2001

Vasculitis of the internal carotid artery in Wegener's granulomatosis: comparison of ultrasonography, angiography, and MRI.

A 37-year old male with newly diagnosed, untreated Wegener's granulomatosis including glomerulonephritis, sinusitis, conjunctivitis, arthralgias, and positive cANCA, developed a pulsating tumor in the left submandibular region and a reversible ischemic neurologic deficit. Ultrasonography revealed both a hyperechoic wall thickening of the left proximal internal carotid artery as is known in Takayasu's arteritis and a surrounding hypoechoic region typical for perivasculitis. The wall thickening and the perivascular infiltrate could be less clearly seen by MRI. Ultrasonography, angiography, and MRI demonstrated a 3 cm long, 30%, stenosis. Angiography and MRI additionally found a more distally located kinking of the internal carotid artery that was missed by ultrasonography. Carotid artery vasculitis is a rare complication of Wegener's granulomatosis. In this case ultrasonography was superior to angiography and MRI to visualize the artery wall and the surrounding tissue, but it failed to evaluate the whole distance of the vessel.

Adult↗
PubMed2000

Strategies in management of ruptured aneurysms--own experiences with various therapeutical procedures in severe SAH.

A retrospective analysis of 58 patients with spontaneous SAH was conducted. 33 patients suffered on severe SAH, clinical grading IV and V (Hunt, Hess). 11 died without treatment due to decerebrate rigidity. 22 patients were treated, 16 underwent a clipping procedure and 6 were selected for endovascular coilembolization. A total of 14 SAH were associated with intracerebral, intraventricular or subdural hemorrhages. In fact of these in 10 patients first an evacuation of the haematoma or a ventricular drainage was necessary, two times combined with a decompressive craniectomy. In 4 patients the removal of haematoma was combined with clipping of aneurysm in one operation. After occlusion of aneurysm decompressive craniectomy was required in 3 patients, an evacuation of an intracerebral bleeding in 1 patient. 6 patients needed a permanent shunting system. The outcome according the Glasgow Outcome Score was: 4 died (GOS1), 12 were severely disabled (GOS3) and 6 were moderately disabled (GOS4).

Adult↗
PubMed1993

[Embolization of cerebral arteriovenous malformations--methods and clinical results].

Interventional treatment by neuroradiological embolisation of cerebral arteriovenous angiomas has become an alternative to surgical exstirpation especially in problematic localisations and large-size malformations. Clinical results showing a marked reduction in attacks and recurrent haemorrhages, evident from a three-year report on 17 patients, confirm the value of the method even in case of only subtotal occlusion of the malformation.

Brain Neoplasms↗
PubMed1993

[Indications and methods of peri-radicular therapy and facet block].

A CT-guided pain therapy can be an additional tool in cases with vertebrally caused problems and lesions. The axial CT scan in the altered vertebral segment allows a controlled puncture of the radicular or articular regions and a helpful pain therapy with different injections. The procedure is performed in outpatients.

Analgesia, Epidural↗
PubMed1993

Problems in the balloon occlusion of aneurysms.

From 1987-1991 we performed 20 balloon occlusions in 15 patients with intracranial aneurysms. In 9 patients procedures were technically successful however long term complications included three deaths. In spite of the advancements in the balloon catheter technology fatalities occur restricting the use of percutaneous balloon occlusion to patients with unclippable aneurysms.

Adult↗
PubMed1992

Intraoperative angiography and embolization in intracranial AVM's and aneurysms.

Intraoperative angiography allows for control procedures for exstirpation of arteriovenous malformations and clipping of problematic aneurysms during the entire operation. During intraoperative embolizations, it is especially helpful to see whether the occlusion of the nidus of an arteriovenous malformation is complete. The method is easy to perform; there were no complications in 19 cases.

Catheterization↗
PubMed1992

[Magnetic resonance tomography in the follow-up after the embolization of arteriovenous malformations of the central nervous system].

Interventional embolisation is an accepted treatment for intracranial or spinal arteriovenous malformations. Since multiple embolizations are often required, noninvasive repeatable follow-up studies are desirable. The aim of this study is to demonstrate the usefulness of T2-weighted images, MR angiography, and gadolinium-DTPA first-pass studies for post-embolisation follow-up studies. Five patients with arteriovenous malformations, four cerebral and one spinal, were studied prospectively before and repeatedly after single or multiple embolizations. A total of 26 MRI studies (1.5 T Magnetom, Siemens AG) were performed. The combination of T2-weighted images, MR angiography, and gadolinium-DTPA first-pass studies nicely demonstrated the arteriovenous malformations and the effect of embolisation which ranged from negligible to almost complete. While contrast-enhanced T1-weighted images and contrast-enhanced MR-angiography seemed to be of little more value than unenhanced studies, gadolinium-DTPA first-pass studies appeared to be more sensitive than T2-weighted images or MR-angiography because of their high intrinsic sensitivity to regional blood flow and volume. In the spine, T2-weighted images and MR-angiography were too insensitive to detect arteriovenous malformations, whereas gadolinium-DTPA first-pass studies sensitively detected the malformation and the changes after embolizations.

Adult↗
PubMed1989

[CT-guided puncture biopsies of cystic processes in the cerebral and spinal areas].

Cystic space occupying processes are well imaged by CT because of their low density. For localization and identification of the surrounding brain structures additional coronary or secondary cuts can be used. Measurements of distances and angles from the intended point of puncture allow, with an appropriate technique, a free-hand puncture of the cyst. Needle position must be recorded with CT-images. No complications occurred in 22 patients. Punctures of cysts have only a symptomatic and transient effect. The immediate pressure reduction and the improvement of the clinical condition of the patient, however, can be valuable as an intermediate measure before surgery.

Biopsy, Needle↗
PubMed1988

[Interventional radiology in neurosurgery--on the use of endovascular balloon occlusion].

A report is given on our experience gained in the introduction of the method of detachable microballoon catheters in the sense of the intervention neuroradiological operative technique. Twenty patients with arteriovenous angiomas, bag-like aneurysms, a carotid Sinus vernosus fistula and intracranial tumours rich in blood vessels were treated according to this method. Adjoining procedures such as embolisation are discussed.

Arteriovenous Fistula↗
PubMed1988

[Diagnosis and therapy of ventral sacral meningoceles].

On the basis of the example of two observations symptomatology and therapy of the ventral sacral meningocele are discussed. Besides the clinical diagnosis, the combination of myelography and computer tomography show the greatest informative value. The therapy should be a surgical one with the aim of the extirpation or elimination of the cellular bag.

Adult↗
PubMed1988

[Complications of Forestier disease affecting the cervical vertebrae as seen from a neurosurgical point of view].

In the presence of Spondylosis hyperostotica an isolated spondylophytary ventral ossification leads to the stiffening of the vertebral column with a considerable loss of elasticity. Patients with a rarely occurring participation of the cervical vertebral column are particularly endangered by traumata. Even a trivial trauma may lead to the fracture or a spinal canal diameter in the lower normal range lead to neurological symptoms. The degree of the instability and the neurological symptoms determine the therapeutical approach. The strategy of the treatment is discussed on the basis of the example of six patients from two neurosurgical clinics.

Aged↗
PubMed1985

[Cerebellar complications following operations in the spinal region].

A report is given on three patients in whom after interventions in the region of the vertebral column and the spinal cord haemorrhages in the area of the posterior cranial fossa had occurred. An excart diagnosis is only possible by exact neurological findings and computer tomography. The causes of these complications are discussed, therapeutically there is only the restoration of the cerebrospinal fluid passages through the efferent systems.

Adult↗
PubMed1983

[Neuroradiologic diagnosis of diastematomyelia].

A report is given on 5 patients with diastematomyelia, in one case the fissure formation of the marrow being without a provable septum. In the frequently very complex pathological-anatomical conditions of the spinal dysraphic malformation, CT can be a considerable help. In combination with metrizamide myelography, details of the marrow parts and their envelopes can be demonstrated. The preoperative planning of the marrow separation becomes more exact. Other causes of a deep spinal marrow level (tethered cord) such as teratomas can also be recognized by CT.

Diagnosis, Differential↗