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Biomedical subjects

K Dei-Anang

Publications and source records attributed to K Dei-Anang.

10 recordsLinked to original sources
PubMed1992

Prevention of deep vein thrombosis in neurosurgical patients: a prospective double-blind comparison of two prophylactic regimen.

In a prospective, randomized, double-blind investigation of anticoagulant agents for prevention of deep vein thrombosis in patients undergoing operations at the lumbar-vertebral disc, 179 patients were randomly allocated to two groups. 87 patients received a fixed combination of low-molecular weight heparin 1,500 U-aPTT plus dihydroergotamine 0.5 mg (LMWH/DHE) once a day and additionally one injection of placebo per day, 92 patients received a fixed combination of sodium heparin 5,000 U plus dihydroergotamine 0.5 mg (HDHE) twice a day. Treatment was initiated two hours preoperatively in both groups and continued for at least seven days. Deep vein thrombosis (DVT), detected by the 125Iodine-labelled fibrinogen uptake-test, occurred in four patients treated with LMWH/DHE and in three patients with HDHE. In all seven patients phlebography was performed, confirming the diagnosis of DVT in one patient of the LMWH/DHE group and in two patients of the HDHE group, only. No increased bleeding was found in either group. Especially no neurological complications caused by epidural bleeding were observed. We therefore recommended to treat routineously all patients undergoing operations at the vertebral disc with antithrombotic agents. The advantages of the once daily regimen with low-molecular weight heparin include better patients' acceptance and less nursing time.

Adult↗
PubMed1990

Clinical follow-up after surgery of lumbar disc prolapses. A critical analysis.

A retrospective clinical study was made on 987 patients with lumbar disc disease treated by discectomy. All patients had been operated on in the Department of Neurosurgery (University-Hospital Mainz). 545 patients were males, and 442 females (1.2:1). Patients in the 4th decade of life were affected most often (33.5%). Perioperative complications occurred in 5.4%, with discitis as the single major complication (1.9%). 83% of all patients who underwent discectomy could return to their normal occupation.

Adolescent↗
PubMed1990

Epidural spinal abscesses.

Fifteen cases of peridural empyemas are reported. 12 patients reported with motor dysfunction of the lower extremities and pain radiating from the spine. In one case, localized pain of the spine was discovered and in two cases there were no signs of spinal or radiating pain. Treatment in all cases was laminectomy and systemic antibiotic administration. Microbiological analysis showed staphylococcus aureus in 11 cases. 9 patients recovered with no neurological defects, two had major improvement of the paresis, and one died. Three patients with paraplegia recovered from the primary infection.

Back Pain↗
PubMed1990

Cerebral aneurysms: assessment of 377 cases (1956-1982).

A review of 177 patients with cerebral aneurysms is made, out of whom 106 with ruptured aneurysms were examined, whose operational timing and prognostic chances were well documented (group B, 1979-1982) and in part updated to 1984. Furthermore, relevant data of a previous series of 200 cases of cerebral aneurysm, treated between 1956-1978 were used (group A). The patients were graded according to Hunt and Hess, assessing the risks involved. The percentages of recurrent bleeding were in group A 36.5% and 28% in group B. The incidence of vasospasm (as seen in angiography) was in group B 39.6% (42/106 patients). The highest rate of vasospasm in the spasm group division B was found to occur in the second and third week after subarachnoid haemorrhage and amounted to 64.7% and 62.5%. A pre-operatively present vasospasm had no negative effects on the mortality rate, but influenced the outcome for the survivors effectively. The total mortality in group A was 22.5% and in group B 11.7%. Timing of the operation among patients in Hunt and Hess-grades I and II needs to discussion. The surgical position of patients in grade V is also certain. What remains to be discussed and needs attention is grade III and patients in grade IVa. Here the time of operative intervention must be planned individually depending on the course of the neurological status.

Cerebral Angiography↗
PubMed1990

Management of giant aneurysms.

Technical aspects and anatomical difficulties involved in the management of this entity and the risks associated give giant aneurysms a special place in the treatment of aneurysms as a whole. The direct attack needs careful planning and the right choice of instruments, especially clips. In spite of the progress in recent years, the rate of mortality is still very high. The indirect approach requires in many cases the occlusion of a major cerebral vessel, which in some cases could result in cerebral ischemia. However, by means of extra-intracranial by-pass operation this risk could be reduced. The method of balloon embolisation has progressed recently. This procedure brings the least discomfort to the patient. Results of this method of treatment must be observed critically for future assessment.

Adolescent↗
PubMed1990

[Percutaneous nucleotomy: an alternative to chemonucleolysis?].

In this study, we compare two groups of patients treated with chemonucleolysis (CNL) (101 patients) and percutaneous nucleotomy (PN) (100 patients) for sciatic pains. Indications for treatment were drawn along similar lines. The patients treated with CNL originated from the Department of Neurosurgery, University Hospital in Mainz and underwent treatment between 1983 and 1987. The second group with PN were from the teaching hospital in Wiesbaden and were treated during 1987 and 1988. Postoperatively, 80% of the CNL group showed good results. However, postoperative progress was slow with back spasms as a common uncomfortable side effect. In 72% of the patients in the PN group, successful treatment was demonstrated with results occurring almost immediately after treatment.

Adult↗
PubMed1989

Cerebral arachnoid cyst: a lesion of the child's brain.

39 patients with 42 arachnoid cysts have been reviewed in a retrospective study. All kinds of arachnoid cysts reported in the literature were also found in this study. These consist mainly of congenital primary and post-traumatic secondary cysts. Cysts which cause no major neurological deficits require conservative treatment of symptoms only. Cysts which cause major symptoms because of their space occupying nature, however, require surgical treatment. Craniotomy with removal of membranes to allow free physiological circulation of CSF is the treatment of choice in our hands. Cysto-peritoneal shunting is an alternative procedure for patients in a poor condition. More than 50% (23 out of 39 cases) were younger then 20 years of age, suggesting that these cysts are mainly congenital lesions of the brain.

Adolescent↗
PubMed1989

[Treatment of spontaneous intracerebral hemorrhage--operative or conservative?].

The current treatment of spontaneous intracerebral hematomas is reviewed, and the results in the literature as well as our own experience on the subject are discussed. It is evident that modern diagnostic methods and follow-up observation periods have led to a sharp decline in the need for operative treatment. The diverse forms of clinical treatment and the remaining indications for neurosurgical intervention are presented.

Cerebral Hemorrhage↗
PubMed1987

[Chemonucleolysis. Method, indications and results. Review].

Since 1963 Chemonucleolysis [CNL] with discase and collagenase has served as a supplementation to the surgical approach in the treatment of prolapses of lumbar disks. The world-wide stated rates of successful treatments amount to about 70 per cent. For a further correction of the result surgical treatments are considered to be necessary in about 20 per cent of the cases. Our experience gained with these measures shows a success in 70 per cent of the patients. The frequency of operations still lies around 18 per cent in accordance with the international standard. This therapy, however, should not be considered to be a fully valid alternative or substitute. If exact indications are present, it can make a surgical intervention superfluous in selected cases.

Follow-Up Studies↗