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Biomedical subjects

H Palleske

Publications and source records attributed to H Palleske.

At least 19 recordsLinked to original sources
PubMed1995

Influence of aneurysm location on the development of chronic hydrocephalus following SAH.

The incidence of chronic hydrocephalus was analysed in a series of 204 patients with aneurysmal subarachnoid haemorrhage (SAH). Its development was significantly related to the quantity of subarachnoid blood, but even more to the location of the haemorrhage and to the aneurysm site. Hydrocephalus was more frequent in patients under poor initial condition. Whereas intracerebral haemorrhage did not increase the risk of chronic cerebrospinal fluid (CSF) resorption disturbances. Patients with intraventricular haemorrhage or voluminous haemorrhage in the basal cisterns have a significantly higher risk of such a complication. In this series 30 (15%) patients developed chronic hydrocephalus and required shunting. Surprisingly, in our series a shunt was never needed in patients with aneurysms of the middle cerebral artery (MCA). SAH from an aneurysm of the internal carotid artery (ICA) also never caused a shunt-dependent hydrocephalus except in cases with accompanying intraventricular haemorrhage. The percentage of chronic hydrocephalus was relatively high (19%) in patients with anterior communicating artery (ACoA) aneurysms but definitely highest in patients with an aneurysm of the vertebrobasilar (VB) system (53%).

Adult↗
PubMed1994

Stereotactic microresection of small cerebral vascular malformations (SCVM).

Between 1988-1993 we performed CT-stereotactic guided microsurgical resection as a one-session-procedure in 46 patients bearing small (< 30 mm) cerebral vascular malformations (SCVM). The location of the SCVM was deep subcortical in 38 patients, temporal medio- basal in 3 and brainstem in 5. The surgical technique intended to minimise invasiveness by reducing the operative approach to a size less than the diameter of the lesion concerned. The mean diameter of our SCVM's was 20 mm ranging from 10 to 30 mm. Histologically we found 23 arteriovenous malformations, 22 cavernous malformations and 1 capillary telangiectasia (capillary malformation). Clinical symptomatology consisted mainly of seizures, (progressive) neurological deficit and (minute) acute intracerebral bleeding. The SCVMs could be demonstrated by contrast-enhanced CT as well as by MRI. 15 of the AVM's revealed as angiographically occult. Complete microsurgical resection of the SCVM was accomplished in all cases with a surgical morbidity of 6.5% and no operative mortality. In 14 patients, most of them with initial acute intracerebral haemorrhage, the pronounced focal neurological deficit improved. During the follow-up period (1/2-5 years) no rebleeding occurred. As far as epileptic seizures were concerned 13 patients became seizure-free without anticonvulsants and 11 patients seizure-free with anticonvulsant, in the remaining 4 patients seizures were reduced in frequency.

Adolescent↗
PubMed1992

Subdural effusions: determination of contrast medium influx from CSF to the fluid accumulation by computed tomography as an aid to the indications for management.

In 46 patients with subdural effusions CSF dynamics and especially the influx of contrast medium from CSF to the subdural fluid accumulation was investigated by serial computed tomography (CT). In 16 cases the subdural effusion was of traumatic and in 30 cases of non-traumatic origin. The results allowed a subdivision of the patients into three groups. Group 1: patients without contrast medium influx into the subdural fluid accumulation; group 2: patients with delayed influx; group 3: patients with immediate influx. In group 1 patients the subdural effusion acted as a space-occupying process with absolute indication for surgical treatment. Also in group 2 patients the further course showed that a surgical indication was given, because the fluid accumulation did not resolve under conservative management but increased in size, and/or the neurological deficit worsened. In all group 3 patients the subdural effusions decreased and finally disappeared conservatively. Group 1 patients with effusions on traumatic origin generally had more severe injuries than the patients of the other groups. The investigations caused no serious complications. This diagnostic method proved to be a reliable means for early differentiation between the possibility of conservative management or the indication for operative treatment in cases with subdural effusions of different origin.

Adolescent↗
PubMed1982

[Computer tomographic ventriculography (author's transl)].

A method for elucidating complex abnormalities of CSF circulation by using a positive contrast medium (metrizamide) and computer tomography is described. The technique for the method, the results and their clinical significance is demonstrated. The value of this method is compared with traditional ventriculography and with computer tomography without the use of contrast medium. It is shown that the technique represents an important extension of the scope of computer tomography.

Adolescent↗
PubMed1981

[Diagnostic and therapy of head injuries in childhood (author's transl)].

The fundamental diagnostic and therapeutical procedures on head injuries in children are described, whereby questions, which are important for paediatric surgeons are given special attention. At the same time the importance of a uniform terminology is pointed out, to guarantee better communication between the different clinics and disciplines.

Brain Injuries↗
PubMed1976

[EEG after so-called whiplash injury of cervical vertebral column (cervicocephalic acceleration trauma)].

The results of electroencephalographic examinations made on four groups of patients are compared. These groups include 80 patients with cervicocephalic syndromes due to flinging injuries to the cervical vertebral column, 80 patients with postconcussive syndromes, and 39 patients whose anamneses suggested conditions resulting from the two kinds of injury referred to above. A fourth group of 40 patients with nontraumatic spondylosis deformans cervicalis is compared with the first three groups of patients. The rate (49 percent, 52 percent, and 54 percent), kind, and distribution of electroencephalographically determined abnormalities are in agreement with those obtained for the first three groups. For patients with nontraumatic cervicocephalic syndromes the rate of general alterations determined from records obtained by means of the electroencephalograph is equal to the occurrence of constitutional EEG variants, the rate being of the order of 10 percent. EEG alterations observed in the case of flinging traumata are considered to de due to acceleration injuries to the cranial contents.

Accidents, Traffic↗