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Biomedical subjects

L Husag

Publications and source records attributed to L Husag.

12 recordsLinked to original sources
PubMed1992

[The current treatment of trigeminal neuralgia. Experience in 162 thermorhizotomies].

The neuralgia of the trigeminal nerve is the most frequent neuralgia of the cranial nerves. It is mostly seen in the elderly. In younger patients it must always be suspected as a symptomatic neuralgia. The course is recurrent and progressive. Spontaneous temporary remissions are usual. Later the pain becomes more frequent, unbearable and disabling. At first the therapy is a conservative one, the drug of choice is Carbamazepin, alternatively Phenytoin and Baclofen. If the conservative therapy fails, the only possible treatment is a neurosurgical one. Nowadays all methods aim at the Gasserian ganglion. In use are several percutaneous transoval procedures or the microvascular decompression through a craniotomy. Our surgical procedure of choice is the percutaneous thermorhizotomy in the Gasserian ganglion and the nerve root, where the pain-conducting fibers are destroyed, preserving tactile sensibility. This procedure is practically without vital hazards for the patient. It is applied in local anesthesia and a short intravenous analgesia. The recurrence rate of 32% is considerable, but the procedure can be repeated. The success cannot be deduced from the recurrence rate alone but must take into account the side effects of the procedure. These are mainly a loss of sensibility to touch by too aggressive rhizotomy and anesthesia of the cornea. By the criteria explained in the text we achieved a good result in 44%, a fair one in 25%, an indifferent one in 10% and a poor result in 7%. In 14% the result is unknown.

Aged↗
PubMed1984

Microsurgical anterior approach to cervical discs. Review of 60 consecutive cases of discectomy without fusion.

During the past six years 60 patients have undergone anterior cervical microsurgical discectomy without exogenous intercorporal grafting using the operating microscope. This alternative method of treatment is a further refinement of previous techniques for the removal of cervical disc protrusions, which fulfils all the criteria of effective surgery. Discectomy provides ample exposure of the neural elements through the disc space. The visualisation of the underlying pathology is adequate through direct light and magnification of the operating microscope. A radical surgery is possible without danger of injury to the nervous structures or to the vertebral artery. The functional stability of the adjacent vertebral segment is, present immediately after discectomy. A spontaneous fusion occurs in 70% of cases in six months to one year. Risks and complications of the procedure are few. Long term results are excellent, with overall benefit from surgery in 95% of cases. Comparing the results of anterior microdiscectomy without bone grafting with those of other procedures, there are no significant differences.

Adult↗
PubMed1984

Spinal epidural hematoma.

Three cases of spinal epidural hematoma are reported, one lumbar, another cervical, and the third thoracic. All were dorsolaterally localized, the first and the third were dependent on anticoagulant therapy, and the second was spontaneous. In addition to the symptoms of sudden onset, acute spinal pain, flaccid paralysis, and loss of sphincter control, the second case had the exceptional picture of a cervical anterior spinal cord syndrome with preoperative transient improvement, followed by the development of Brown--Séquard syndrome with subsequent deterioration. This case was diagnosed by means of computed tomography. The postoperative course has been satisfactory in all patients, with complete recovery in two.

Aged↗
PubMed1984

Persistent hydrocephalus following removal of choroid plexus papilloma of the lateral ventricle.

We report a case of choroid plexus papilloma of the left lateral ventricle, which illustrates the difficulties of diagnosis of these tumours with air studies in advanced hydrocephalus. The hydrocephalus was apparent at the age of three months, but ventriculography failed to reveal the true nature of the communicating hydrocephalus. A ventriculocaval shunt was inserted, but the hydrocephalus progressed, in spite of the fact that the shunt was functioning well. The diagnosis of a papilloma of the choroid plexus was made after performing a CT examination at the age of 3 1/2 years. In spite of radical tumour removal, three years after the operation the axial computer tomography revealed a persistent hydrocephalus, but no recurrence of tumour. To control the hydrocephalus, a bilateral shunt with low pressure valve was necessary. With reference to the literature we discuss the possible causes of persistent hydrocephalus after surgical removal of these tumours. The majority of authors concluded, that because of repeated subarachnoid bleeding by these tumours, it must be a form of aresorptive hydrocephalus. The persisting hydrocephalus is probably caused by an increase of the CSF outflow resistance because of a distal CSF-pathway obstruction.

Cerebral Ventricle Neoplasms↗
PubMed1983

Meningioma of the foramen magnum. Report of a case.

The authors present a typical case of a meningioma of the foramen magnum. Because of the unspecific nature of the patient's symptoms, the present illness had a course of more than seven years. During the last two years of the illness, the diagnosis of multiple sclerosis was assumed. The final diagnosis was established by computed tomography followed by vertebral angiography. The tumor removal was followed by dramatic recovery of the patient. The value of axial and direct coronal computed tomography is emphasized.

Adult↗
PubMed1981

[Antero-lateral, cervical microsurgical diskectomy].

We report 25 cases of cervical disc lesion, treated with antero-lateral microsurgical discectomy without intercorporal graft. The posterior osteophyts were removed and the posterior longitudinal ligament lateral resected. In the control period of 6 months to 4 years we have in 84% of cases excellent/good results clinically and radiologically and concerning the working capacity. Comparing the results with 51 other cases operated on with the fusions technique after Cloward, there are no significant differences. We give a short description of the technique and review the literature.

Adult↗
PubMed1980

[Neurinoma of the cauda equina (author's transl)].

A rare case of a mobile neuroma of the cauda equina is presented. Myelography, first done by lumbar puncture, showed the tumor at the L1 level. A second myelography, done by suboccipital puncture, showed the tumor at the L3 level, 7 cm more caudal as in the first myelography. Reviewing the literature, 2 similar cases were found. The so-called redundant nerve root is discussed as a possible explanation of the mobility of the tumor. The importance of the precise preoperative tumor localisation is stressed.

Adolescent↗
PubMed1978

[Hemangioblastoma of the cauda equina].

Hemangioblastomas are dysontogenetic tumors of the central nervous system. They occur as single tumors or multiple. Hereditary and sporadic cases are known. The most frequent localisations are the retina and cerebellum but they can be localized at any site of the neuraxis. In a 37 year old male patient a solitary hemangioblastoma of the cauda equina was demonstrated by myelography and totally removed by laminectomy. In the literature 17 cases of isolated hemangioblastomas of the cauda equina are described. A further 16 cases of were observed within a Lindau-complex, 10 of which remained without symptoms. For diagnosis of the type of tumor a myelography is rarely sufficient. The only successful therapeutic measure is total surgical removal.

Adult↗
PubMed1978

[Spontaneous intraorbital hematoma].

A case of spontaneous intraorbital Haematoma is reported. A girl aged 13 years developed an acute unilateral Exophthalmos on the right side with disturbances of eye-motion, choked disc and nearly complete amaurosis within 3 days after onset. The etiology of the bleeding remains unknown. The diagnosis of orbital haematoma was made by the clinical picture and the computerized axial tomography (CAT) findings. Through a lateral orbitotomy was the extraperiorbital haematoma evacuated, with a complete recovery within two weeks. Twenty-two cases of the literature are reviewed. The possible aetiologic causes are discussed: haemorrhagic diatheses, arterial, vasomotoric and toxic diseases, the congestive and traumatic causes mentioned. The clinical picture and diagnositc procedures, especially the CAT, are reviewed. The surgical treatment with stress on the lateral orbitotomy is discussed.

Acute Disease↗
PubMed1976

[Unilateral hydrocephalus due to membranous occlusions of the foramen of Monro (author's transl)].

A case of dilatation of the right lateral ventricle due to membranous occlusion of the foramen of Monro is reported. A child aged two and a half years developed raised intracranial pressure together with disturbed consciousness, but other neurological defect, two months after after an attack of bilateral broncopneumonia. The preoperative diagnosis of occlusion of the right foramen of Monro by infiltrating tumour was made angiographically. At operation the obstruction was found to be due to a membrane. The septum lucidum was fenestrated and a ventriculoatrial shunt was inserted. After a year the shunt was removed. Twenty eight cases of unilateral hydrocephalus due to nontumorous occlusion of the foramen of Monro have been reviewed, and the aetiologies have been discussed. Clinical picture and diagnostic procedures are reviewed. The authors discuss surgical treatment, and lay stress on fenestration of the septum lucidum.

Brain Diseases↗
PubMed1975

[Extrapyramidal symptoms in meningiomas].

We report 2 cases of sphenoid ridge meningeomas with symptoms of a parkinsonian sydrome, one of them contralaterally, the second bilaterally. Both did not respond to specific antiparkinson treatment. The extrapyramidal symptoms disappeared in both cases promptly after removal of the tumor. In the first case they reappeared temporary in connection with a local wound-infection. The histological examination of the second case, which died on a pulmonary emboly, showed no alterations of the cerebrum in the sense of an idiopathic or postencephalitic M. Parkinson. The authors try to show possible corrlations by means of the relevant literature (total 75 cases). It is found, that extrapyramidal symptoms do not allow uniequivocal localising or specific conclusions referring the kind of tumor or lesion. Nevertheless the meningeomas preponderate, excluding the basal infiltrating tumors. Referring to the localisation, the frontal located meningeomas preponderate. The bilateral meningeomas all lead to bilateral extrapyramidal symptoms. Next it especially also the frontal meningeomas of convexity mostly cause bilateral extrapyramidal symptoms. In the majority of cases the diately after operation, the rest during weeks to months. Finally the authors discuss the possible pathophysiologic mechanism of origin according to the literature.

Adolescent↗