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Biomedical subjects

J Wappenschmidt

Publications and source records attributed to J Wappenschmidt.

At least 37 records · Page 2Linked to original sources

Facilitation of removal of a hypervascularized cervical vertebral body tumour by intraoperative temporary occlusion of the tumour-feeding vertebral artery, using intraarterial catheterization.

The surgical treatment of a highly vascularized tumour that destroyed the fourth cervical vertebral body in a young patient, without neurological deficits, is reported. After posterior stabilization an anterior approach was used in order to replace the affected vertebral body with an acrylic prosthesis. The tumour-feeding vessels originated largely from the right vertebral artery. In order to maintain optimal visibility, intraoperative haemorrhage was kept at a minimum by temporarily occluding the tumour-feeding vertebral artery with an intraarterial catheter.

Adolescent↗

The meningioma of the sphenoidal plane.

The present paper reports on meningioma of the sphenoidal plane. Four women and two men were investigated. All cases examined presented with impairment of visual acuity, optic atrophy, and visual field defects. The interval between onset of the disease and a noticeable space-occupying growth was 11.5 years. Frequent false diagnoses and the importance of clinical-roentgenological follow-ups at regular intervals are especially emphasized.

Adult↗

[The clinical and radiological picture of degenerative disease of the extra- and intra-cranial vessels (author's transl)].

The clinical and angiograms of 500 patients with degenerative disease of their cerebral vessels were evaluated. The clinical severity of the ischaemic changes was graded and compared with localisation and extent of the angiographic abnormality. In these patients there is an increased risk during angiography and a careful technique has to be employed. Two examples are used to show that it is possible to clarify even complex neurological and angiographic problems by means of an appropriate technique, 90% of our patients with a definite cerebral infarct gave a history of previous transitory ischaemic attacks. In our opinion patients with these attacks are of particular interest to the angiographer and the surgeon.

Adult↗

[Experimental artificial embolization in animals: consequences and clinical applications (author's transl)].

A fistula was created between the jugular vein and the common carotid artery in rabbits. The fistula was demonstrated by angiography and embolized using material labelled with iodine 131. The embolization material used was fibrin, Tabotamp, and Lyo-Dura. The migration of the emboli was registered by scintigraphy with an Anger camera. The experiment showed that the embolization material is transported from the small to the great circulation.

Animals↗

[Anastomosis between carotis externa and carotis interna circulation (indication and results) (author's transl)].

An extra-intracranial anastomosis operation was carried out in 60 stroke patients in order to bypass the occlusion or severe stenosis in the internal carotid or middle cerebral artery. Postoperative angiographical follow-up studies showed a well functioning extra-intracranial bypass in more than 90 % of the patients. In many cases repeat angiography done weeks or months following surgery revealed an enlargement of the caliber of the extracranial artery used for constructing the bypass and also of the cerebral arteries that were irrigated by the bypass. Furthermore we noted that the new collateral channel was able to fill a steadely increasing part of the cerebral circulation and that it was also found to irrigate territories of the brain that were previously well perfused by leptomeningeal anastomosis or retrograd flow through the ophthalmic artery etc. resulting in a reversal of the direction of blood flow in these collaterals. The neurological follow-up examinations revealed that the increase in cerebral blood supply following the extra-intracranial anastomosis operation resulted in a considerable improvement of the post-stroke neurological deficits.

Carotid Arteries↗

[Observation of the course of craniopharyngioma].

A case of craniopharyngioma with an unusually long history is reported. The patient developed his first symptoms 44 years ago. After 2 to 3 years the patient became completely blind in both eyes. Now the tumour is calcified and as big as "a fist". Recessive processes seem to be the explanation for cessation of growth in the tumour.

Blindness↗

[Atypical termination of the vertebral artery and of the inferior posterior cerebellar artery (author's transl)].

A rare varient in the termination of the vertebral artery is described associated with a low origin of an unpaired inferior posterior cerebellar artery lying between C. 1 and C. 2. This is illustrated radiographically. An attempt is made to explain this radiologically and to classify it. Possible clinical significant of this anomaly, particularly in relation to subarachnoid haemorrhage, is discussed.

Abnormalities, Multiple↗

[Angiographical findings in extra-intracranial anastomoses (author's transl)].

A microsurgical anastomosis between the superficial temporal artery and a cortical branch of the middle cerebral artery was carried out in 11 cases with internal carotid occlusion. This treatment was attempted following angiography of the intra- and extracranial cerebral arteries. After the microsurgical procedure for creating an extra-intracranial arterial anastomosis selective angiography of the homolateral external carotid circulation was performed. The analyses of the serial arteriograms showed, that a) a considerable blood supply from the external carotid circulation through the additional collateral pathway to the territory of the middle cerebral artery is possible, b) the extent of the area of the middle cerebral artery supplied by the superficial temporal artery is not only dependant upon a pressure gradient between the external carotid and the middle cerebral artery circulation, but also by the different anatomical variations of the middle cerebral artery.

Adolescent↗

[Dissecting aneurysm with damage to median nerve].

A case of iatrogenic dissecting aneurysm in the cubital region causing secondary damage to the median nerve is reported. This aneurysm was caused by an attempted venipuncture, in what can be considered a minor procedure. Such a severe complication is very remarkable, for it has not been observed so far even in much more potentially hazardous procedures as, for instance, in the numerous arterial punctures in the cubital region being daily performed for retrograde angiography of the cerebral vessels. In this case the reduced blood coagulation is discussed as a causing factor of this unusual complication.

Aneurysm↗