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Biomedical subjects

K Zeiler

Publications and source records attributed to K Zeiler.

At least 73 records · Page 4Linked to original sources
PubMed1986

[Status of oral contraceptives as a risk factor in cerebrovascular diseases].

A critical review of the relevant literature revealed that the incidence of subarachnoid haemorrhage is increased in women taking oral contraceptives and the mortality rate is higher. The data concerning correlation between the use of oral contraceptives and other cerebrovascular disorders are less conclusive. Taking oral contraceptives seems to result in a higher risk of stroke, but there is no definite correlation to the incidence of strokes with a fatal outcome. However, in the case of the coexistence of more than one risk factor, including cigarette smoking, the risk of cerebrovascular disease is considerably increased for women using oral contraceptives. Age also seems to be a significant factor. Women older than 44 should avoid oral contraceptives in general; women between 35 and 44 should use oral contraceptives only if additional risk factors are absent, i.e. if they are non-smokers. Indeed, in the presence of this or other risk factors younger women should also avoid taking oral contraceptives.

Adult↗
PubMed1986

[Prognostic significance of initial loss of consciousness in cerebrovascular disorders].

An initial loss of consciousness is of grave prognostic significance in patients with acute ischaemic cerebrovascular disorders, both as regards the early course as well as the long-term prognosis. The aim of this study was to assess the prognostic importance of an initial loss of consciousness in patients who had survived the acute stage. Thus, 133 out of 139 patients suffering from ischaemic cerebrovascular disorders who survived the first 3 weeks after a stroke were clinically re-examined after a mean follow-up period of more than two years. The other 6 patients had died as a result of a second stroke in the post-acute period. Patients with an initial loss of consciousness suffered cerebrovascular disturbances or fatal strokes in the follow-up period slightly more frequently than patients without an initial loss of consciousness. However, there were no convincing differences between the two groups. Indeed, on follow up, patients with an initial loss of consciousness were slightly less socially disabled than patients without an initial loss of consciousness. The results suggest that an initial loss of consciousness is no longer a factor of prognostic importance in patients who have survived the initial stage.

Brain Ischemia↗
PubMed1985

[Therapy of organic psychosyndromes of cerebrovascular origin with a vasoactive drug combination].

Concrete cross-sectional studies of the organic brain syndrome, carried out periodically, attempt to establish for the parameters evaluation of substrate damage--and different noopsychopathological rating-scales for the measurement of brain capacity impairment. Beyond the level of the purely correlative-statistical point of view of the relationship between parameter and score changes, demanding for a quantitative model which could provide not only a description, but also an explanation for such a relationship. The fact that there can only be a question here of a "quantitative causality" embracing non-specificity of toxic substances and relative to acute and chronic diffuse organic brain syndromes. It results, that quantitative causality meets the requirements of an exponential function model and that one can validate such models through correlative-statistical methods. This has already been carried out by Ball and Taylor.

Adult↗
PubMed1985

[Balloon catheter technic and embolization--new therapeutic approaches in cerebral and spinal blood vessel malformations].

Balloon catheter and embolization techniques continue to gain importance in the therapy of cerebral and spinal vascular malformations. These methods are applied either preoperatively to improve outset conditions for the operation or as an independent therapeutic measure to partially or completely bypass the malformation. So far the balloon catheter and embolization techniques are applied only within a limited field. Nevertheless, this fairly recently developed method is already indispensable in the therapeutic repertory. There are as yet no generally acknowledged principles with regard to indications for these procedures. Therefore, neurologists, neurosurgeons and neuroradiologists have to be included in the process of decision making.

Angioplasty, Balloon↗
PubMed1985

[The cerebral angiogram in patients with complicated migraine].

38 patients (mean age: 29 years) were investigated by means of complete 4-vessel angiography: all of them were suffering from complicated migraine without detectable vascular malformation. Stenoses of the great craniocervical vessels were found in 11 patients (28.9%), but there was not a single case of vascular occlusion. A correlation between the localization of the stenosis, the localization of the headache and the presumed region of the transient cerebral function disturbance was found only in a few patients. Concerning the morphological changes of the small intracranial arterial branches, there was hardly any difference between clinically affected and non-affected territories of the middle cerebral artery. The angiograms of the 38 cases of complicated migraine were compared with the angiograms of 40 patients suffering from strokes in the young and those of 49 patients with transient ischaemic attacks. There were remarkably fewer stenoses or occlusions in the great craniocervical arteries of patients suffering from complicated migraine (28.9%) than in the vessels of cases of stroke in the young (52.5%). However, the incidence was comparable with the results in patients with transient ischaemic attacks (34.7%). The degree of morphological changes in the small intracranial arterial branches is likely to depend primarily on the patient's age and less on the diagnosis. The results suggest that in almost 30% of patients with complicated migraine-even at juvenile age-stenoses of the great craniocervical vessels might be found.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Cerebral angiography in complicated migraine--reactions, incidents].

Seventy-one patients (ages: 15-58 years) suffering from complicated migraine were investigated by means of cerebral angiography which was not performed during an attack. Angiography was carried out to exclude stenoses or occlusions of the cranio-cervical vessels and above all vascular malformations (arterial aneurysms, arteriovenous angiomas). In 18 cases (25.4%) organic lesions were found, including three vessel malformations (4.2%). Thirty-one patients (43.7%) suffered from headache reactions or other complications during or within 24 h following angiography. In 15 cases (21.1%) attacks of complicated migraine were observed, three patients (4.2%) suffered from headache and bilateral flickering visual disturbances, another 11 patients (15.5%) developed headache and vegetative symptoms requiring therapeutic management. One patient (1.4%) got an epileptic seizure, another patient (1.4%) developed a generalized urticaria exanthema. There were more headache reactions in women than in men. However, the highest percentage of reactions was observed in patients in whom migraine headache had occurred clearly set off from the transient cerebral functional disturbances. Neurological complications (transient functional disturbances) occurred in 16 of 71 patients (22.5%). The neurological complication rate was significantly (P less than 0.001) higher than that in an unselected group of patients (3.0%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

[Contribution of cerebral angiography to the prognosis of juvenile stroke].

46 patients (aged 13 to 40 years) suffering from ischaemic cerebrovascular disease were investigated by means of complete 4-vessel angiography. 40 of these patients were re-examined after a mean follow-up period of 57 months. The aim of the study was to investigate possible connections between the angiographic data and the clinical condition some years later. In the 37 patients who were not subjected to surgical treatment prognosis was not significantly different in cases with, and those without stenoses/occlusions in the craniocervical vessels. However, patients suffering from severe stenoses/occlusions had a significantly worse prognosis than patients with stenoses of a mild degree. The clinical course in patients with stenoses/occlusions localized in the vertebro-basilar system was significantly more favourable than the course of the disease in patients with similar changes in the carotid system. There was a trend towards a worse clinical picture at the end of the follow-up period in cases with degenerative alterations in the small intracranial arteries. The difference in prognostic value of cerebral 4-vessel angiography in cases of stroke in the young, as opposed to the findings in older patients is discussed.

Adolescent↗
PubMed1984

[Long-term prognosis of patients with juvenile infarct. Catamnestic results].

Seventy patients suffering from ischemic cerebrovascular disease had had their first attack before the age of 40 years. Of these patients 57 were re-examined 84 months (mean) after the initial event. Within 48 months, 22 of 51 patients (43.1%) without surgical treatment had recurrent ischemic events (78.6% patients with transient ischemic attacks, 33.3% patients with protracted reversible deficits, 28.6% patients with completed stroke). Of all patients 31.5% had their first recurrent attack during the first year, most of them during the first few months after the initial event. In spite of the considerably higher recurrence rate, patients with initial transient ischemic attacks or protracted reversible deficits had a lower degree of social disability at the end of the follow-up period than patients with an initial completed stroke. In 72.2% of the patients with recurrent events the ischemic focus was found in a vascular area different from the one originally concerned. Patients with arterial hypertension during the follow-up period had a somewhat less-favorable long-term prognosis, but nicotine abuse or relative body weight had no influence on the degree of social disability at the end of the follow-up period. In general, long-term prognosis was rather favorable, 78.4% of the patients being fully capable of work at the end of the follow-up period. Nevertheless, results point to the necessity of complete diagnostic evaluation without delay and introduction of individual therapy for patients suffering from "juvenile stroke."

Adolescent↗
PubMed1981

[Diagnostic value of dynamic scintigraphy in cases of cerebrovascular disease (author's transl)].

Serial and sequential scintigraphy is amongst the most important noninvasive screening methods for the diagnosis of stenosing or obliterative processes in the carotid territory. In order to check the reliability of the method, the scintigraphic findings in 150 patients were compared with the results of cerebral panarteriography. In the proximal portion (in the neck) there was agreement in 78.7%. Some under-estimation and over-estimation was found in 9% and 8.3%. False positive scintigraphic results were obtained in 2.3%, false negative results in 1.7% of vessels. In the distal territory (carotid syphon/middle cerebral artery) there was agreement in 87.9%. Some over and under estimates occurred in 5.7% and 6.4% respectively. The commonest causes for false positive and false negative results are discussed.

Adolescent↗
PubMed1981

[Clinical and angiographic findings in vascular medullary syndromes (author's transl)].

Eleven cases presenting a syndrome of the medulla oblongata are discussed with reference to the findings of clinical and angiographic investigation. The diagnosis of Wallenberg's syndrome is justified when the classic symptoms are apparent (Horner's syndrome, nystagmus, dysphonia and dysphagia, ataxia, ipsilateral sensory impairment of the face and contralateral elsewhere, and accompanying vegetative disturbances). If additional symptoms such as a facial or extra-ocular muscle paresis, especially hemiparesis, exist, another, more lateral or medial, syndrome of the oblongata should be considered. Angiographic findings vary considerably, ranging from a normal vertebral artery or posterior inferior cerebellar artery (PICA) to an occlusion of these arteries (in three and two of the 11 cases respectively). Modification are often seen in the anterior inferior cerebellar artery (AICA). A kind of complementary supply in the PICA-AICA region must occasionally exist. Localised processes affecting these vessels rather than diffuse multifocal vascular processes would lead to Wallenberg's syndrome. It is difficult to conclude from the clinical picture where a possible responsible vascular narrowing or obliteration may lie, even if pareses of the limb were present.

Adult↗
PubMed1980

[Correlation between clinical and angiographic findings in cases of transient cerebral circulatory disturbances (author's transl)].

The results are presented of angiographic investigations in 85 patients suffering from transient ischaemic cerebral circulatory disturbances. Transient ischaemic attacks (TIA) were observed in 45 patients, reversible ischaemic neurological defects of longer duration (PRIND) were diagnosed in 40 patients. The mean age of all patients at the time of angiography was 49.9 years. Transfemoral cerebral panarteriography was performed in all cases, including studies both of the aortic arch and of the cranio-cervical vessels. The mean interval between the first manifestation of cerebrovascular disease and angiographic investigation was approximately 2 years. 10.6% of all patients showed normal angiograms; in 35.3% of all cases diffuse vessel wall alterations were found; 37.6% showed minor stenoses (vessel diameter reduced to 80-34%), whilst 16.5% showed major stenoses (vessel diameter reduced to 33-1%) or occlusions. There was poor correlation between clinical-neurological localization of the ischaemic lesion and the angiographically-verified stenoses or occlusions. The angiographic findings corresponded to the clinically affected regions in only 52.2% of all patients suffering from stenoses of occlusions. A good correlation was found in 71.4% of the cases when only major stenoses and occlusions were evaluated. Consequently, angiographic studies of the aortic arch, as well as of all extra- and intracranial vessels are a precondition for the surgical treatment of the cranio-cervical vessels in every patient. It is possible by these means only to achieve a comprehensive assessment of the haemodynamic processes in the cerebral circulation.

Adolescent↗
PubMed1980

[The diagnostic value of cranial computerized tomography in exogenous psychoses and mental disorders associated with organic disease (author's transl)].

205 patients hospitalized in a psychiatric department were subjected to cranial computerized tomography. The diagnosis on discharge according to the ICD key in each case was "psychoses or mental disorders associated with physical conditions". Pathological findings were obtained in 67.8% of the patients. In the case of space-occupying lesions the connection between psychiatric symptoms and syndromes and the underlying organic disease is obvious. Moreover, with inflammatory, vascular or traumatic diseases, a relationship to focal lesions found on the computer tomography appears likely if backed by appropriate neurological indications in the history or on clinical examinations. However, when alterations signifying diffuse brain atrophy are obtained on computer tomography any connections with psychiatric features should be very critically evaluated and, in individual cases, such connections had better not be looked for at all. Especially in cases of psychoses or mental disorders associated with physical conditions cranial computerized tomography is of high diagnostic value and the indications for its implementation in these cases should be judged very leniently.

Adult↗
PubMed1980

[Comparative results of neuropsychological investigations, computer tomography and electroencephalography in post-traumatic epilepsy (author's transl)].

Clinical-neurological and neuropsychological investigations, as well as cranial computerized tomography (CT) and electroencephalography (EEG) were performed in 33 patients suffering from verified post-traumatic epilepsy. The purpose of this study was to compare the neuropsychological test scores (dementia, psycho-organic syndrome, decreased vigilance) with the results of CT and EEG. There was no significant correlation between the neuropsychological scores and the EEG results. On the other hand, a significant correlation was found between decreased vigilance (measured by CFF) and the results of CT, both in the case of focal lesions or diffuse brain atrophy.

Adolescent↗
PubMed1980

[Densitometric evaluation of angiocinematographic x-ray films in cerebrovascular diseases (author's transl)].

21 patients suffering from cerebrovascular diseases were examined by means of angiocinematography. The 37 X-ray films were taken under standardized conditions of exposure and development, and were evaluated by use of densitometry. The flow speed and the blood volume/min were measured in the internal carotid artery, as well as the arterial transit time from the carotid siphon to standardized measuring points in the three branch groups of the middle cerebral artery. The haemodynamic parameters obtained from the clinically affected hemispheres or branch groups were compared with those obtained from the clinically non-affected. The aim of this study was to attempt to make a contribution towards the understanding of haemodynamic changes in connection with cerebrovascular diseases.

Adult↗
PubMed1980

[Arteritis in cerebral inflammatory diseases. Diagnostic value of angiography (author's transl)].

Cerebral angiography may sometimes show up inflammatory changes in the brain arteries in cases of tuberculous and acute purulent bacterial meningitis. The arteries at the base of the brain are predominantly affected, in some cases together with peripheral branches. Normal angiograms or non-specific alterations may be expected in patients suffering from non-purulent meningitis and encephalitis. Patients with luetic diseases show circumscribed or diffuse vessel wall lesions which cannot be differentiated from alterations caused by arteriosclerosis. The results are presented of 15 patients suffering from inflammatory diseases of the central nervous system of different aetiology. The morphology and the distribution of the arterial changes in the cerebral angiogram are discussed.

Adult↗