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Biomedical subjects

J K Podgórski

Publications and source records attributed to J K Podgórski.

At least 19 recordsLinked to original sources
PubMed2004

One stage removal of periaqueductal glioma in adult via infratentorial supracerebellar and transaqueductal approaches.

Most cases of periaqueductal tumours were found in children and adolescents, so treatment modalities in adults are not evaluated yet. A case of 40 years old woman with tectal and periaqueductal protoplasmatic astrocytoma grade II with history of headache and episodes of syncope is described. MRI showed triventricular hydrocephalus. After a shunt procedure she was doing well for about 15 months. Then she became somnolent, disoriented, and Parinaud syndrome appeared. The solid tumour was resected microsurgically in one stage. A part of it was removed via the supracerebellar infratentorial approach and tectal plate incision. The remainder of the tumour was removed through the fourth ventricle and the aqueduct which was filled by tumour mass. Postoperatively bilateral ptosis, vertical gaze palsy, slight horizontal gaze limitation and pupilloplegia were the main neurological sequelae. They all almost completely resolved within a year. The patient is doing well two and half years after the surgery. MRI showed patency of the aqueduct and no residual tumour. The authors suggest, that direct surgical attempt at total tumour removal should be considered in cases of periaqueductal and tectal gliomas. They also believe it is the first described case, in whom this type of tumour was totally removed by a combined transtectal and transaqueductal route.

Adult↗
PubMed2002

Turner's syndrome followed by acromegaly in the third decade of life: an unusual coincidence of two rare conditions.

We present an unusual coincidence of acromegaly and Turner's syndrome. A girl was diagnosed with Turner's syndrome when she presented with short stature, primary amenorrhea, Hashimoto's thyroiditis, and some heart and renal anomalies. No therapy with growth hormone and only a few months treatment with estrogen-progestin was given. A typical picture of acromegaly occurred in the third decade of her life. Bone radiographs and densitometry suggested the more pronounced influence of acromegaly within the skeleton, but no features typical for acromegaly were found in the cardiovascular system. To our knowledge no case of coincidence of the above mentioned conditions has been reported to date. The influence of both of these conditions on bones and heart is discussed.

Acromegaly↗
PubMedDate not supplied

[Assessment of regional blood flow in patients after mild head trauma].

Single photon emission computerized tomography (SPECT) using radioisotope markers was applied for analysis of regional blood flow in the brain. The method makes possible demonstration of the presence and extent of damage to the nervous tissue caused by trauma. The degree of blood flow impairment is of prognostic significance in cases of cerebral concussion. In the present study the regional brain blood flow was assessed shortly after trauma and one year in cases of mild cerebral concussion. In the studied group immediately after trauma blood flow impairment was found mostly in the left temporal area and in frontal areas. Changes of rCBI were present also late after trauma. In 7 out of 16 cases SPECT image failed to change one year after trauma. In 8 cases the rCB improved up to normalization. In 1 case the changes progressed, in another case hyperperfusion focus changed to hypoperfusion. In 2 cases the pattern was normal early and lata after trauma. In the studied group in cases with changed rCBF no changes were found in CT and MRI examinations. This evidence a greater sensitivity and usefulness of SPECT in the assessment of early and late consequences of head trauma.

Adult↗
PubMedDate not supplied

[Preoperative administration of a slow releasing somatostatin analog (SR-lanreotide, BIM 23014) in patients with acromegaly in the course of GH-releasing adenoma].

To evaluate the therapeutic efficacy of slow releasing analogue of somatostatin (SR-Lanreotide) in the pretreatment for GH-releasing adenomas, especially macroadenomas. During the last four years (between January 1996 and December 1999) the authors carried out 382 transsphenoidal operations for to various lesions. There were 169 acromegalic patients in this group. 82 of them received, as pretreatment, the slow releasing analogue of somatostatin (SR-Lanreotide, BIM 23014) in a dose of 30 mg every 14 days for 3 months (6 injections). There were 55 women and 27 men (range 25-68, mean age 44.8 years, SD +/- 10 years) operated on by one experienced neurosurgeon. The concentrations of serum GH--70.5 micrograms/l (range 5.3-500 micrograms/l, SD +/- 83.9 micrograms/l) and IGF-I--1302 micrograms/l (range 610-2030 micrograms/l, SD +/- 360.7 micrograms/l) were high. Out of these 82 patients 79 had macroadenomas with suprasellar and parasellar extension. The volume of the tumours was calculated according to the formula of Di Chiro-Nelson. The mean volume of the tumour was 4146.9 mm3 (range 213.5-38595.3 mm3, SD +/- 5675.9 mm3). The response to the pretreatment suppression of the serum GH, IGF-I level and shrinkage of the tumours--were evaluated before surgery. Second MR examination was performed in 38 pretreated patients. During the Lanreotide treatment mean serum GH level decreased from 70.5 to 15.6 micrograms/l (p < 0.0001), mean serum IGF-I concentration decreased from 1302 to 787 micrograms/l and mean volume of the tumour decreased from 5662 to 2326 mm3 (p < 0.0001). During surgery, tumours were observed to be softer, had liquid consistency and were easier removed. 57 patient (69.5%) who underwent surgery had GH below 5 micrograms/l and were cured. Transsphenoidal microsurgical resection of pituitary adenomas is the primary treatment for acromegaly. Lanreotide pretreatment significantly decreased mean serum GH and IGF-I level, shrinks the tumour and make it much softer and easier to be removed.

Acromegaly↗
PubMedDate not supplied

[Value of computerized tomography in the diagnosis of discopathy in the L4-L5-S1 segment].

The aim of this analysis was demonstration of the usefulness of CT in the diagnosis of lumbar discopathy. In 110 patients with backache, CT of the L4-L5-S1 part of the spine was done. The observed abnormalities were analysed, including presence of nucleus pulposus herniation, pathological changes of osseous structures of the spine, width of the vertebral canal and lateral recesses, and presence of other lesions there. Comparing the results of (CT) and myelography with intraoperative observations it was possible to confirm the high usefulness and value of CT in such cases. CT may be an important diagnostic method preoperatively in patients with iodine hypersensitivity and those with vertebral canal stenosis.

Adolescent↗
PubMedDate not supplied

[Radiological diagnosis of iatrogenic stenosis of the lumbar spine in patients after surgical treatment of intervertebral disk displacement].

Iatrogenic stenosis of the vertebral canal arises as a result of inflammatory changes of the arachnoid with formation of adhesions following irritation of the meninges with chemicals, such as drugs and contrast media, or extension of the intracranial scar tissue, usually after operations. This stenosis is a serious diagnostic and therapeutic problem being often the cause of lacking improvement or recurrence of radicular pains after operations for herniated nucleus pulposus. On the basis of a literature review and own experiences the authors discuss the aetiology, pathogenesis, radiological diagnostic methods and methods of treatment in cases of iatrogenic postoperative stenosis of the lumbar vertebral canal.

Adult↗
PubMedDate not supplied

[Our evaluation of the usefulness of CUSA in poorly accessible brain tumors and intramedullary tumors].

The intention of this report is to present the experience with CUSA gathered in an over 5 year period of time in operations of tumours of various characteristic and localization. The subject of this evaluation is the usefulness of CUSA NS-100, which has been in constant use in the Neurosurgical Department of CCH MMS since February 1986. The material includes 163 patients with brain and intraspinal tumours, which were entirely or partly removed using CUSA. The tumours were located in basal region of the skull, posterior fossa, other regions of the brain and spine. Most of those tumours histologically were meningiomas, gliomas, neurinomas, invasive adenomas of hypophysis and craniopharyngiomas. The analysis of the obtained results decisively contradicts the current opinion of CUSA versatility and its almost unlimited possibilities. Its usefulness is limited only to selected cases. The radicality of the operation is still conditioned by many factors, the most important of which are location of the tumour and its sensitivity to ultrasounds.

Brain Neoplasms↗
PubMedDate not supplied

[Intracranial hematoma as a complication after surgical treatment of meningiomas].

The causes of postoperative haematomas after operations for intracranial meningiomas are analysed. The percentage of this complication in this material was 5.2%. The most frequent concomitant disease in this series was arterial hypertension. The majority of postoperative haematomas was observed after longer lasting operations with totally excised large tumour. Perhaps, one of a large number of causes, is slight coagulopathy.

Adult↗
PubMedDate not supplied

[Value of computerized tomography and magnetic resonance imaging in difficult diagnosis of the cases of pituitary adenoma].

Thanks to endocrinological and radiological diagnostic improvement and development of pituitary adenoma neurosurgery, CT-examination became a routine examination in such cases, in selected situations supported with MRI-examination. The authors report a short bibliography review of radiologically difficult cases, explained thanks to CT and MRI-examinations.

Adenoma↗
PubMedDate not supplied

[Anterior transposition of the ulnar nerve in the cubital area-- a contribution to the treatment of reflex sympathetic dystrophy].

A variety of symptoms makes difficult the diagnosis and causes therapeutic problems after blunt limb trauma, particularly after long time from the immediate treatment. Three cases of sympathetic reflex dystrophy of the ulnar nerve as a late consequence of blunt upper limb traumas are presented. Long-term medical and surgical treatment produced temporary remission only. Full efficiency of the limb and remission were achieved only when anterior transposition of the nerve was done.

Adult↗
PubMedDate not supplied

[So-called mirror injuries in severe head trauma].

Severe head traumas cause high mortality. It was the reason to analyze such a group of patients, treated in the Neurosurgical Department of the CCH MMA in the years 1980-1990. All cases of mirror injuries were divided into three groups. The lesions of frontal and temporal lobes present brain-stem lesion like syndromes. Personality disorders were associated with lesions of both frontal lobes. The third syndrome is caused by focal lesions according to their location. The authors discuss medical and surgical treatment and stress the importance of early brain protection.

Brain Injuries↗
PubMedDate not supplied

[A case of primary abscess of the pituitary gland].

This report details the management of a patient with a primary pituitary abscess with secondary amenorrhea, mimicking pituitary adenoma. The preoperative diagnosis of intra- and suprasellar pituitary abscess was established by X-ray examination of the skull, CT-scans and anamnesis. After transsphenoidal removal of the abscess with accompanying antibiotic therapy the patient had a progressive and nearly complete recovery with normalization of menstruation.

Abscess↗
PubMedDate not supplied

[A case of intrasellar craniopharyngioma with the symptoms of pituitary apoplexy].

Craniopharyngiomas account approximately for 2.5% of all intracranial neoplasms. They statistically most often arise in Japanese people (8%) and in children (9%). Despite their typical localization in suprasellar region and their close neighbourhood, 10-20% of them occupy intrasellar space, but only very few grow up as intrasellar cysts. Such localization predisposes to hypothalamus-pituitary-axis dysfunction more often, than other localizations. The symptoms of pituitary apoplexy caused by sudden, intrinsic haemorrhage of intrasellar craniopharyngioma are very rare, because the tumour grows very slowly and its vascular supply is usually poor. A very rare localization, extremely atypical course of disease, interesting intraoperative observations and good results of transsphenoidal tumour removal prompted the authors to present this case report.

Adult↗
PubMedDate not supplied

[Cerebral blood flow changes after mild head trauma imaging with SPECT HMPAO. Preliminary report].

The authors present 3 cases of mild head trauma diagnosed by CT, EEG and SPECT. The results showed that CT scan was negative in all cases while SPECT was positive. EEG recording showed changes which seemed to agree with the changes of regional cerebral blood flow presented by SPECT. This initial results indicate that SPECT HM-PAO within the first two-three days is more sensitive than CT scan and detects brain perfusion abnormalities.

Adolescent↗
PubMedDate not supplied

[Difficulties in the diagnosis of cerebral abscess in a 15-year old boy with von Recklinghausen disease treated surgically: recovery case report].

A case of neurofibromatosis type 1 in 15 years old boy is presented. Recurrent intracranial bleedings, epileptic seizures and brain abscess were the main manifestations of the disease. The authors suggest that hamartomatous cerebral lesion with vascular abnormalities might be responsible for such a picture of the disease.

Adolescent↗