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Biomedical subjects

H Zettler

Publications and source records attributed to H Zettler.

At least 19 recordsLinked to original sources
PubMed1990

[Brain function monitoring].

EEG and multimodal evoked potentials are currently the most frequently used methods of brain functioning monitoring in severely acute primary or secondary brain damage. Development or regression of brain function disturbances can be reliably assessed in this way. The methods are suitable for early diagnosis of intracranial complications and contribute to diagnosis of irreversible loss of cerebral function. They are also useful for early prognosis assessment. EEG and evoked potentials can be monitored at the bed-site. If there are no technical facilities for long-term EEG monitoring, repeated conventional single tracings are of value in these cases. When both the acoustic evoked brain stem potentials and the early somatosensory potentials are to be examined, the possibility exists to differentiate between hemispheric and brain stem damage and to use these results for prognosis assessment.

Brain↗
PubMed1989

[Computerized tomography and electroencephalography findings in post-traumatic brain edema].

The reduction in size of the ventricular areas in the computer tomogram as a morphological substrate of a generalised cerebral edema in 43 patients correlated better with the vigilance than with the EEG findings. This fact as well as the representation possibility of additional intracranial haemorrhages favour the computer tomography in the posttraumatic acute phase as compared to the electroencephalography, which should be employed in the subacute phase.

Adolescent↗
PubMed1988

[The relative importance of the brain stem acoustic evoked potential (BAEP) in patients with brain stem tumors].

The brain stem acoustic evoked potential is a non-invasive procedure at the disposal of neurological diagnostics that permits to obtain information about the functional condition of the brain stem. As regards the question of the topodiagnostic possibilities of this examination method in patients with brain stem tumours the BAEP parameters were compared with the clinical symptoms existing at the time of the examination as well as with computer tomographic findings. There is a good agreement of the severity of the clinical symptoms and the distinction of the BAEP changes. In case of unilateral BAEP changes or BAEP changes with a pronounced accentuation on one side indications with respect to the lateral localisation of the brain stem tumour in connection with the clinical findings can be derived. An exact topodiagnosis of brain stem tumours is exclusively possible by the correlation of clinical symptoms, results of picture-yielding examination methods and BAEP examination.

Adolescent↗
PubMed1988

[The value of auditory evoked brain stem potentials in the diagnosis of circulatory disorders in the area of vertebrobasilar circulation].

The acoustically-evoked brain-stem potential in patients with vertebrobasilar insufficiency has enjoyed a varied diagnostic evaluation in the literature. Our own examinations reveal an advantage in subdividing AEBP changes into normal and marginal, slight and pronounced, within a group of patients with blood supply disorders in the vertebrobasilar region. AEBP permits inferences to be made on the extent of the damage. However, one should be chary of referring AEBP change of vascular origin to any particular section on the basis of these deductions alone. Only the comprehensive consideration of clinical symptoms, AEBP findings, and neuroradiological examination leads to a valid opinion on extent and location.

Adult↗
PubMed1987

[Interpretation of paroxysmal slow activity--"subcortical signs"--in the electroencephalography of adults].

Slow paroxysmal EEG activity, also referred to as "subcortical signs", offers an indication of impaired subcortico-cortical functional interaction that may be set off as a result of intracranial processes of a wide range of localisation. For this reason, the occurrence of this EEG pattern should not be taken to indicate a primary localisation in the range of the medical subcortical structures, nor does its absence imply any improbability of extensive lesions in the region. Taking into consideration the form and frequency of the waves during paroxysms and their local distribution, even this aspecific pattern yields more information for the clinical diagnosis. In particular, generalised paroxysms from monomorphic delta waves are usually associated with an existing primary or secondary brain illness, and would suggest the need for further diagnostic clarification. In interpreting the slow-wave groups restricted to the temporal regions, frequently counted among the "subcortical signs", the wave frequency and the patient's age must be taken into account. In the second half of life they frequently occur unaccompanied by any pathological process.

Adult↗
PubMed1985

[Are subcortical signs in the EEG a reliable indication of brain stem displacement and impaction processes by intracranial space-occupying processes? A comparative computer tomography-electroencephalography study].

Within the scope of an elektroencephalographic-computertomographic comperative study carried out in 430 patients, the concurrence of secondary brain stem damage due to mass displacement and herniation processes and parroxysmal generalised slow activity in the EEG ("intermittant frontal delta rhythms", "projected discharges", "subcortical signs") in intracranial space-occupying processes were studied among others. The occurrence of the EEG pattern was independent of the presence of brain stem displacements in about 20 and 25 per cent, respectively, of the 152 patients with supratentorial space occupations. The absence of the characteristics on 80 per cent of the patients with clear CT criteria for a secondary brain stem impairment shows that it is not suitable as a warning sign of an imminent intracranial decompensation and that in particular from the non-occurrence in the EEG no contribution to the operative risk and to the choice of the time of the operation can be derived. A relation between the occurrence of paroxysmal slow activity and the acuity of the course of the disease or the degree of malignity of cerebral tumours could not be verified. Possible causes of the inconstant occurrence of this EEG pattern in brain stem alterations are discussed.

Adolescent↗
PubMed1985

[Irreversible cerebral function loss (so-called brain death). Further experiences in diagnostic procedures].

Analyzing international 15 years experiences the authors characterize the present situation of knowledges and practical possibilities concerning brain death diagnostics. It must be differentiated between generally accepted obliging criterions and the remaining space of responcibility of the neurologist, who is acting as a member of a brain death commission. In this frame procedures have to be chosen, which allow to diagnosticate without any doubt and as early as possible. Further developmental possibilities are shown.

Brain Death↗
PubMed1984

[Standardized monitoring of brain function].

A form is described for recording the results obtained when monitoring the brain function in cases of severe acute brain damage. The form follows the principles introduced in other countries for recording the results of similar standard examinations, but the symptoms and scalings have been modified to suit the author's requirements. The state consciousness as shown by the opening of the eyes, verbal response and motor reactions to various stimuli is considered essential for the continuous monitoring of the brain function, as are also the dilation of the pupile and their response to light and the vestibuloocular reaction. The form also contains entries for respiration, blood pressure, heart rate and body temperature. The neurological symptoms have been selected on the basis of their diagnostic value, consistency and simplicity of examination and interpretation. The advantages of a standard examination scheme are explained. Advice is given regarding the examination of the different symptoms.

Brain Damage, Chronic↗
PubMed1981

[The treatment of epilepsies with Convulsofin].

The testing of Convulsofin carried out in 220 patients at 14 clinics over a period of six months confirms the international experience gained with valproic acid and sodium valproinate. The main field of application of Convulsofin according to the experience gained will again be the treatment of fits in generalised primary epilepsy for which it permits to carry out a monotherapy to a remarkable extent. The favourable effect of the preparation in photosensitivity could be confirmed. Also in generalised secondary epilepsy and in fits of partial epilepsy. Convulsofin is partly effective, so that it can recommended as a co-medication in the treatment of therapy-resistant forms of these epilepsies which are difficult to treat. Decrease in thrombocytes, transient increase in serum transaminases, gastrointestinal disorders, loss of hair and undesired increases in body-weight were the more frequently occurring side-effects.

Adolescent↗
PubMed1981

[Prognosis using computerized tomography in acute coma].

A total of 98 patients, who had been in a comatose state of different aetiology (with the exception of endogenic and exogenic intoxications) for more than twelve hours, were reclassified into two prognostic groups by means of the linear discrimination analysis. The separation procedure was based on 20 neurologic and general-clinical characteristics according to a scale of up to 10 steps. The degree of separation reached varies between 86 and 100 per cent (mean success rate 91-100 per cent). The probability of the individual patients being grouped into the correct class of prognosis increased by repetitions of the calculations within short time intervals. Clinical symptoms are sufficient for the establishment of the prognosis. Possibilities of an increase of the reliability of the separating procedure are discussed.

Brain Damage, Chronic↗
PubMed1980

[Prognostic clinical criteria in comatose conditions].

A total of 98 comatose patients were reclassified according to the final stage of the disease by means of the discrimination procedure after Fisher. Those neurological symptoms and general clinical data were ascertained that were most important for the separation. The order of the characteristics according to their contribution to the separation shows a dependence upon the time of the examination. The different distinctiveness and degree of intensity of neurological symptoms are of different importance to the division of the patients into certain prognostic classes. The most important studies published until now of individual neurological symptoms and other clinical characteristics for the prognosis in severe acute cerebral lesions have been compiled.

Adolescent↗
PubMed1979

[Oral automatism in acute coma].

Of 98 patients in ai acute state of coma different etiology, 18 (or 18.4 percent) showed series of rhythmic oral motions ("chewing automatisms"). Only one of these patients was observed to develop an apallic syndrome. The characteristic features of chewing automatisms and their concomitant symptoms are described, and the need for delimiting them from more differentiated oral-motor patterns is emphasized. Both forms are of different importance to an assessment of the respective course of disease. The observation of chewing automatisms in acute states of coma does not allow the incipient development of an apallic syndrome to be inferred.

Acute Disease↗