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J Wisławski

Publications and source records attributed to J Wisławski.

At least 19 recordsLinked to original sources
PubMed1993

Pituitary apoplexy: endocrine, surgical and oncological emergency. Incidence, clinical course and treatment with reference to 799 cases of pituitary adenomas.

Authors analyzed retrospectively the incidence of pituitary apoplexy in a series of 799 pituitary adenomas with respect to the long term follow-up of the patients. Focal vascular abnormalities in histological specimens of tumours, regarded as morphological suggestion of past apoplexy (haemorrhage, ischaemic infarction or necrosis), were established in 113 out of 783 surgical cases (14.4%). Acute clinical onset, justifying the clinical diagnosis of pituitary apoplexy, occurred in 39 patients only (5% of the whole series), 19 of them were subjected to urgent surgical decompression due to severe neurological deficit. The haemorrhagic character of apoplexy was established in most cases requiring immediate surgery. The detailed clinical picture of this condition and its management are discussed with respect to the long term prognosis. On this basis the authors suggest the necessity of surgical treatment in every case of pituitary apoplexy, taking into account not only neurological recovery, but also endocrine and oncological aspects of the disease. The observation that pituitary apoplexy may be a "marker" of tumour invasiveness (even in small, "enclosed" adenomas) is highlighted.

Adenoma↗
PubMed1989

[Erdheim's tumors in adults--diagnosis, treatment and therapeutic results].

The authors present a group of 27 adult patients aged over 25 years treated in the Department of Neurosurgery, Medical Academy in Warsaw in the years 1960-1985 for Erdheim's tumours. In most cases the first signs were visual disturbances and signs of raised intracranial pressure, and in only 48% of cases endocrine disturbances were additionally found. The basic diagnostic method in these cases was computerized tomography which indicates precisely the location of the lesion, its consistency and width of ventricles. All patients were treated surgically, the operative surgery was 14.8%. The authors believe that surgical treatment followed by radiotherapy is the best method of management of such tumours in adults.

Adult↗
PubMed1985

Results of neurosurgical treatment by a transsphenoidal approach in 10 patients with Nelson's syndrome.

Ten patients with Nelson's syndrome, nine women and one man, aged 22 to 61 years, were treated neurosurgically by a transsphenoidal approach. In four patients, microadenomas were found, ranging in diameter from 4 to 10 mm. Microscopically, mixed adenoma was diagnosed in six cases, basophilic adenoma in three patients, and chromophobe adenoma in one patient. The presence of argyrophilic nerve fibers in the adenoma tissue was noted in one case. The time of observation after transsphenoidal surgery ranged from 6 months to 10 years. Clinical remission was achieved in eight patients; in two of them, radiation therapy was used to complement surgical treatment. In two patients, recurrence of the pituitary neoplasm was observed; anaplasia was revealed at the second operation in one of them. Radiation therapy might be a useful adjunct to neurosurgery in Nelson's syndrome, especially in patients with anaplastic adenoma.

Adenoma↗
PubMed1983

Nelson's syndrome: incidence and prognosis.

Fifty patients bilaterally adrenalectomized for Cushing's disease were followed for 1 to 22 (mean, 12) years. In 14 of them (28%) Nelson's syndrome appeared within 1.5 to 12 (mean, 4.8) years after adrenalectomy. All the patients were deeply pigmented, 12 had a radiologically demonstrable tumour and six had visual defects. Plasma ACTH levels ranged from 450 to 8000 ng/l. However in every case at least one estimation during circadian studies equalled 2000 ng/l. One patient with an anaplastic pituitary tumour died 3 years after the discovery of the tumour. Anaplasia was also diagnosed in another patient with recurrence of pituitary tumour after a transsphenoidal operation. Symptoms of tumour infarction occurred in two patients, followed by clinical remission of Nelson's syndrome. In the majority of cases the course was benign. We conclude that all cases, however, should be followed indefinitely because Nelson's tumours are not infrequently aggressive.

Adenoma↗
PubMed1981

Late results of operation in temporal lobe epilepsy in adults and children.

In our clinic at the Medical Academy in Warsaw 282 patients with temporal lobe epilepsy were treated surgically. The causes of the illness were trauma in 43.2%, including birth trauma in 19.5%, infections diseases in early life in 19.8%, and microtumours in 6.8%. In 30% the aetiology was unknown. Fifty per cent had fits before 10 years and 75% before 20 years of age. The period of conservative treatment was on average nine years. Serial and stereo-EEG recordings including activation by ketamine, as well as intracarotid sodium amytal tests were performed routinely. The interictal EEG epileptiform abnormalities were found most frequently in both temporal lobes (154 cases). The operation was carried out according to Penfield's technique, with electrocorticography and resection of the temporal lobe extending for 6 to 10 cm in the nondominant hemisphere and for 4 to 5 cm in the dominant hemisphere using suction technique. In 75% microscopical changes in the hippocampus were found, in 20% so-called hamartomas and in 6.8% small gliomas. Two patients died and in 13 patients there was a hemiparesis which was transient in 10. The authors present the analysis of late results of 262 cases with a follow-up from 2 to 22 years after operation. Very good results were obtained in 127 cases (48.5%) - no attacks since leaving the clinic. Good results were observed in 42 patients (16%) - not more than 1-2 attacks a year. Thus, the operation resulted in freedom from attacks, or nearly so, in 169 cases (64.5%). In an additional 47 patients (18%) there was a significant reduction (at least 50%) in seizures without complete freedom from attacks, and in 44 cases (16.8%) no improvement was observed. The analysis of our series suggests that the best results may be obtained in patients with unilateral temporal EEG changes. The existence of an additional focus in parts of the other temporal lobe does not impair the operative results when the dominant epileptic focus has been removed. Among 24 cases with equally pronounced bitemporal EEG abnormalities the stereo-EEG studies allowed detection of the epileptic focus in 13 patients (54%). Detailed analysis of the results, obtained in 51 children below 15 years of age, led to the conclusion that temporal lobe epilepsy should be operated upon even in young children, provided that the epileptic focus can be clearly identified.

Adolescent↗
PubMed1980

[Microsurgical treatment of cerebral arteriovenous aneurysm].

The authors describe a group of 9 patients with arteriovenous malformations of the brain operated upon using the microsurgical technique and controlled arterial hypotension. In all cases the malformations were radically removed. In one patient the neck of a coexistent aneurysm of the pericallosal artery was clamped with a clip. Disability in one patient was the effect of haemorrhage, another patient with hemiparesis is being rehabilitated. The remaining patients are feeling well and in only one of them epileptic seizures remained after the operation, they had, been however, present before the operation. The use of the microsurgical technique makes possible reduction of the surgical trauma to the brain tissue and opens greater possibilities of intraoperative evaluation of radical performance of the operation.

Adolescent↗
PubMedDate not supplied

[Teratoma of the posterior cranial fossa].

Two cases of posterior cranial fossa teratomas are reported. The rarity of these lesions is stressed. In the material of surgically treated cases of brain tumours from a period of 12 years in only two patients teratomas of this location were found. In adults they are extremely rare. In both cases teratoma finding during the operation was a surprise for the neurosurgeons and this was confirmed by literature reports.

Adult↗
PubMedDate not supplied

[Many-year survival after surgical treatment of glioblastoma multiforme. Report of 2 cases].

Two female patients are described with survival over 13 years after operation for glioblastoma multiforme. The first patient was 42-year-old at the time of partial removal of the tumour situated in deep parts of the temporal lobe. After the operation she was not given any radiotherapy. CT done 13 years after the operation failed to show tumour presence. The patient is leading a self-dependent life (80 points in Karnofski scale). The other female patient was 28-year-old at the time of nearly complete removal (macroscopic) of right temporal lobe tumour. She received cobalt radiotherapy. CT 9 years after the operation showed no tumour. The present state of the patient was evaluated at 90 points Karnofsky scale. In no case cytostatics were given. These cases demonstrate an exceptionally long survival after operation for malignant glioma. The cause of this long survival is not known.

Activities of Daily Living↗
PubMedDate not supplied

[Postoperative radiotherapy of glial tumors of the central nervous system].

The authors analysed the survival time of 372 patients subjected to radiotherapy after operations for central nervous system tumours of glial origin. Subtentorial gliomas with a better prognosis than supratentorial gliomas accounted for 82% of cases in this group of 67 children, and cerebellar medulloblastoma most sensitive to radiation accounted for 85%. In the group of 305 adults supratentorial tumours were found in 90.8% of cases, and the very malignant multiform glioblastoma was present in 50.8% of cases. In view of these differences the five-year survival rate was 31.3% in children than 40 years; no sex differences were found between the groups with different survival rates. Postoperative radiotherapy of malignant gliomas is of great value prolonging the life of the patients and improving its quality.

Adult↗
PubMedDate not supplied

[Neuropathologic analysis of 8 undiagnosed cases of cerebral cysticercosis].

The presented material comprised 17 cases observed in four Warsaw hospitals in a period of 20 years. Nine patients with the pseudotumour syndrome were diagnosed correctly and referred to neurosurgical services. The remaining eight cases died in neurological hospital departments with the following clinical diagnoses: cerebral stroke 3, subarachnoid haemorrhage 1, comatose state preceded by dementia 1, chronic meningoencephalitis 1, status epilepticus 2 cases postmortem investigations demonstrated cerebral cysticercosis in all cases. In four patients with predominant symptoms of cerebrovascular disease lesions were found of the type of residual vasculitis cysticercosa, the sequelae of which might have caused secondary complications independent of concomitant arteriosclerosis. Dementia appeared in a patient with huge hydrocephalus consequent to numerous cysticerci. The patient with the diagnosis of meningoencephalitis had an inflammatory reaction of the ependyma and meninges caused by a cysticercus floating in the IV ventricle. Of the patients dying in status epilepticus attention is called to a 6-year-old girl with a solitary cysticercus localised subcortically in the motor area. The authors suggest that the possibility of cysticercosis should be kept in mind, despite its rarity, in cases with a not completely clear clinical manifestations of cerebrovascular disease, chronic meningoencephalitis and epilepsy or dementia.

Aged↗