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Biomedical subjects

J C Grosslercher

Publications and source records attributed to J C Grosslercher.

4 recordsLinked to original sources

Electrophysiological monitoring in the intensive care unit.

Spontaneous electrical activity (EEG) and event-related computer averaged brain electrical potentials (EPs) are becoming an integral part of CNS function monitoring in neurological intensive care patients. EEG monitoring using the compressed spectral array (CSA) computer analysis offers continuous information about cerebral electrical activity, permitting an accurate definition of the severity of brain injury, forecasting patient's course, and early detection of secondary intracranial changes. It offers more precise indications for treatment and prognosis. Combining EEG with multimodality EPs permits a finer diagnosis of the location and extent of CNS damage and contributes information, not otherwise obtainable, on the integrity of CNS pathways. Changes is electrophysiological patterns are often related to changes in other physiological parameters or events affecting the patient. Consequently, it appears advantageous to monitor simultaneously other CNS and body functions and record, process and display the data obtained in the patient care area. To make this comprehensive monitoring system reliable and useful, a wise application of advanced computer technology and a high degree of understanding of intracranial dynamics are required.

Brain

[Open-door decompressive cervical laminotomy. Technic and initial experiences].

The cervical laminectomy is usually applied in the treatment of cervical myelopathy caused by cervical canal stenosis and multiple spondylosis. Nevertheless, late complications are often reported, especially scar formation, the so-called laminectomy membrane, between the dura and overlying paraspinal muscles, which, compressing the cord, reduces until to abolish the favourable effects of the previous laminectomy; moreover, malalignment of the cervical spine with secondary kyphosis may follow an expansive laminectomy. In order to avoid these complications, in 1977 Hirabayashi introduced a new surgical technique, the "expansive open-door laminoplasty", which permits the enlargement of the spinal canal over multiple segments by completely incising the laminae laterally on one side and partially on the opposite: elevation with tilting of the laminae upward in the incised side, allows enlargement of the canal. The Authors describe in detail the operative procedure and report their experience in 10 patients.

Adult

Experience in "radical" surgery of supratentorial gliomas in adults.

This study reports the preliminary results obtained in a series of 107 patients with histologically proven malignant gliomas (86 glioblastomas and 21 anaplastic astrocytomas) operated upon between 1986 and 1989, with an aggressive attitude aimed to achieve extensive and possible "radical" excision of the tumor. Gross total removal was achieved in 62% of cases, while in the remaining the postoperative contrast enhanced CT scan showed more than 10-15% of residual tumor mass. There was no operative and postoperative mortality. The one-year survival rate was 60% in patients with total removal and 24% in those with partial resection. Furthermore the Karnofsky rating at discharge was improved in the former group while was unchanged in the latter. Although preliminary, these data seem to confirm the primary positive role of radical surgery in the combined management of malignant gliomas.

Glioma