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Biomedical subjects

J Wroński

Publications and source records attributed to J Wroński.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

[Transcranial doppler ultrasonography monitoring in patients with intracerebral hematoma due to aneurysm rupture].

The aim of the study was to evaluate the influence of intracerebral haematoma due to aneurysmal rupture on vasospasm evaluated by transcranial Doppler ultrasound and outcome according to Glasgow Outcome Scale. 368 patients with ruptured intracranial aneurysm were admitted to the Department of Neurosurgery, Medical Academy in Wrocław, between January 1, 1995 and June 30, 1998. Patients were divided into two groups. In group I there were 74 patients with subarachnoid haemorrhage and intracerebral haematoma. In group II 294 patients with subarachnoid haemorrhage. Despite intensive monitoring and treatment the outcome of patients with subarachnoid haemorrhage and intracerebral haematoma is worse than in patients with subarachnoid haemorrhage only.

Adolescent↗
PubMedDate not supplied

[Management of patients with multiple intracranial aneurysms].

A retrospective analysis of 142 patients with multiple intracranial aneurysms operated on within eight years (1991-1998) was undertaken. In 82 patients multiple aneurysms were clipped during one procedure in the remaining 60 patients operation was performed in two stages. The clinical state of patients according to Hunt-Hess scale at the admission to the department was assessed, as well as the presence of blood on the initial CT scan according to Fisher scale and outcome according to Glasgow Outcome Scale. The operative results patients with multiple intracranial aneurysms are worse, than those with single aneurysm, which is connected with the necessity of wider exposure of cerebral vessels and possibility of bleeding from unclipped aneurysm, when operation is performed in two stages.

Adolescent↗
PubMedDate not supplied

[Familial occurrence of hemangioblastoma].

Haemangioblastoma is a benign vascular neoplasm accounting for approximately 1-2% of all intracranial tumours. Patients with haemangioblastoma are aged usually about 40 years, the tumour is situated mostly in the cerebellum, more frequently in males. The tumour is a component of the Hippel-Lindau syndrome with familial-hereditary dominant aetiology, often associated with retinal angiomatosis, cysts of the pancreas and kidneys, renal carcinoma and phaeochromocytoma. A familial haemangioblastoma is reported in father and son. The father had the tumour in cerebellar vermis but the son had multiple tumours in cerebellum and medulla.

Adult↗
PubMedDate not supplied

[Results of postoperative treatment of patients after brain tumor removal based on the cerebral circulatory pressure index (CCPI) in comparison with ICP and CPP].

The aim of the study was the assessment of prognostic value of CCPI in relation to the results of treatment of patients with increased intracranial pressure after brain tumour operative treatment. The results of treatment of 107 patients with intracerebral tumours according to neurological state at the introduction of treatment (GCS) and initial values of ICP, CPP and CCPI as well as final results of treatment (GOS) are analysed. A special normogram collecting all of these parameters was constructed, as well as the directions of treatment depending on the areas of MABP, ICP and CPP were established. The CCPI seems to be more a sensitive and earlier signals suggesting the urgency and the direction of treatment than ICP and especially CPP alone. There seems to be a great consistence of the patient state evaluation according to GCS, GOS and CCPI which is also a prognostic factor. All the patients with initial CCPI below 1.5 died while all the patients with CCPI over 3.0 in good and very good neurological state, and all the patients with initial CCPI between 1.5 and 3.0 had neurological deficits.

Blood Flow Velocity↗
PubMedDate not supplied

[Analysis of own clinical material treated by conservative and aggressive control of intracranial hypertension].

These problems arising during the treatment of increased intracranial pressure (ICP) were analysed on the basis of own clinical material with consideration of different therapeutic methods--pharmacological and aggressive. Statistical analysis (contingency tables) showed that the treatment consisting of dexamethason, mannitol and furosemid was the most efficient in the group of patient with increased ICP in the range 15-30 mmHg. In patients with ICP in the range 30-50 mmHg, where other aggressive methods of treatment had failed, the most efficient treatment was cranio-dural decompression.

Dexamethasone↗
PubMedDate not supplied

[Infusion test in the selection of patients with hydrocephalus for the shunting].

The indications for the shunting of the patients with NPH are a matter of discussion. The measurement of the outflow resistance during the infusion test is one of the criteria for shunting. The authors present 38 patients with NPH in whom the lumbar constant-infusion test was carried out. The patients with the outflow resistance more then 13 mmHg/ml/min were selected for shunting. The results at least 4 months after operation are presented.

Adolescent↗
PubMedDate not supplied

[Posttraumatic vasospasm and its treatment with nimodipine].

The aim of our study was to compare the incidence and the time course of vasospasm as well as outcome of patients with tSAH. In group I there were 15 patients treated with nimodipine. Group II consisted of 20 patients in whom nimodipine was not used. All patients suffered from severe head injury, scored 8 points or less according to Glasgow Coma Scale. The initial CT scan revealed tSAH in all of them. Outcome was evaluated according to Glasgow Outcome Scale (GOS) three months after injury. Results were better (but not significantly) in patients in whom nimodipine was used, time course of vasospasm was less severe and follow-up CT scans did not reveal ischaemic infarcts connected with vasospasm.

Brain Injuries↗
PubMedDate not supplied

[Acid-base equilibrium in cerebrospinal fluid following intracranial surgery].

In 48 patients the acid-base equilibrium in the CSF and blood was determined on the 2nd day after intracranial operation. In the postopertive period various disturbances of this equilibrium were found which were probably various stages of metabolic acidosis compensation in the CSF which was a reflection of metabolic (lactate) acidosis developing primarily in the damaged brain area. On the basis of determinations it was found that changes in the CSF of the type of metabolic acidosis (21 cases) corresponded most frequently to respiratory alkalosis in the blood (11 cases). Changes of the type of respiratory acidosis in the CSF(13 cases) corresponded usually to metabolic alkalosis in the blood (7 cases). The development of metabolic acidosis in patients in severe and moderately severe condition (19 cases) was associated with poor prognosis as to survival since the mortality in this group was 10 (about 53%). The favourable effect of dehydrating treatment may be due also to facilitation of passage of bicarbonates from the blood into the cerebral tissue and CSF since their level is increased in the blood during metabolic alkalosis (during a decrease in the extracellular space) resulting from dehydration.

Acid-Base Imbalance↗