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Biomedical subjects

J Gonzalez-Darder

Publications and source records attributed to J Gonzalez-Darder.

7 recordsLinked to original sources

Use of intrathecal baclofen administered by programmable infusion pumps in resistent spasticity.

On the basis of previous experimental and clinical studies patients with severe spasticity due to spinal cord damage from multiple sclerosis in 8 cases and postraumatic paraplegia in 6 and resistent to all conservative treatments were selected for a trial with morphine and baclofen administered intrathecally through a catheter placed in the spinal subarachnoid space rostral to the affected segments and attached to a subcutaneous reservoir. Whereas morphine single injection did not show any benefit, baclofen bolus injection 30 to 60 micrograms, revealed a marked decrease of spasticity and associated symptoms in 8 cases. After checking the clinical effect during 3 weeks and changes in electroneurophysiological studies and bladder manometry the catheter was attached to a subcutaneous programmable pump able to be refilled percutaneously and administered baclofen continuously or more often following a multistep complex programme in total doses of 90 to 150 micrograms per day. After a mean follow-up of 5 months all cases showed an absence of spasms and pain, a notable improvement for bettering of sphincter functions and a marked muscle relaxation that improves motor capacity, leading to increased ambulation or mobility. Neither complications nor side-effects were observed.

Adult

Sequential morphological and functional changes in kaolin-induced hydrocephalus.

An experimental model of kaolin-induced hydrocephalus in the dog was studied in order to evaluate the progress of ventricular dilatation and the communications between the ventricular system and the subarachnoid space. Skull and spine radiological studies were obtained after metrizamide intraventricular injection, and the baseline ventricular pressure and cerebral pulse pressure amplitude were measured in anesthetized animals. Intracranial compliance and resistance to drainage of cerebrospinal fluid were calculated by means of bolus injection test. Light and scanning electron microscope studies were done at different developmental stages of hydrocephalus. With these experimental parameters, two successive phases were seen: an initial acute hypertensive hydrocephalus (H1) with high resistance, low compliance, severe ependymal damage, and subependymal edema; and a late chronic normotensive hydrocephalus (H2) with little resistance increase, normal compliance, epithelial regeneration, and subependymal gliosis. Both the H1 and H2 stages showed an increase in the cerebral pulse pressure amplitude.

Animals

Burr-hole electrocorticography.

In 17 epileptic patients, most of them with seizures of partial type but with diffuse or focal alternating abnormalities in the electroencephalographic recordings, chronic implantation of subarachnoid electrodes was performed. Through two bicoronal burr-holes and under fluoroscopic control, 13 to 19 insulated monopolar flexible electrodes were introduced in the subarachnoid space, conducting them either to standardized cortical targets, or concentrating them in that area of interest showed by conventional EEG. The electrodes were placed bilaterally and symmetrically, and remained implanted for 10 days. During this period, the activity of multiple foci, the reciprocal dependence between them, its reaction to cortical electric stimulation, barbiturate administration and sleep, were studied. No morbidity was found. Because of the simplicity and safety of this technique, it appears to be a good diagnostic method placed between conventional EEG and stereoelectroencephalography.

Electric Stimulation